Lorena Alicia Villarreal de Cantu, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8085892-1206 Issued in UT

Practice address

5285 S 400 E
Washington Terrace, UT 84405-7194

Phone

(801) 393-5355

Fax

(801) 394-4609

NPI assigned

Nov 21, 2011

Sex

Female

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)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Midtown Community Health Center Inc

  dba Midtown CHC Children's

  • Federally Qualified Health Center (FQHC)
  • Washington Terrace, UT
  • NPI 1013186717
  NPD (past)
• Midtown Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Ogden, UT
  • NPI 1548267420
  NPD (past)

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1679840599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011511",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 S 400 E",
            "city": "WASHINGTON TERRACE",
            "state": "UT",
            "postal_code": "844057194",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL DE CANTU",
        "first_name": "LORENA",
        "middle_name": "ALICIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8085892-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rolanda Daisy Steele
• Therapeuo Health
• Timber Ridge Holdings LLC
• Amanda Kathryn Trease, COTA
• Utah Orthopaedics LLC
• Washington Heights Healthcare, Inc. (Mt. Ogden Health and Rehabilitation Center)
• Wayne E Smith MD PC
• Weber Human Services
• Western States Medical LLC
• Jill Willis

• Physician Assistant in Washington Terrace, UT
• Providers in Washington Terrace, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.