Michael Villanueva, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31341 Issued in CA

Practice address

3252 Holiday CT Ste 225
La Jolla, CA 92037-1809

Phone

(858) 352-6802

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1679786941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3252 HOLIDAY CT STE 225",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371809",
            "telephone_number": "858-352-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3252 HOLIDAY CT STE 225",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371809",
            "telephone_number": "858-352-6802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2240 Shelter Island Dr # C114",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921063131",
            "country_code": "US",
            "telephone_number": "951-743-1197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2024-04-02",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blayne Michael Vidrine
• Joseph Francis Viglotti, MD
• Laura Ann Vilardi, NP
• Heather Renee Villani, M.D.
• Benito Villanueva, MD
• Johanna Villarreal, MD
• Adelbert M Villoso, PHARMD, MS
• Berlin Vincent
• Stanton Ray Vincent, DO
• Victoria Marie Vincent, PHYSICIAN ASSISTANT

• Clinical Psychologist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.