Charis Mandujano Villagomez

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2403 Professional Dr Ste 101
Santa Rosa, CA 95403-3007

Phone

(707) 544-3295

NPI assigned

Nov 4, 2019

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

Practice roles

Locations

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

• Drug Abuse Alternatives Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Rosa, CA
  • NPI 1629856430
  NPD
• Drug Abuse Alternatives Center

  • Addiction (Substance Use Disorder) Counselor
  • Santa Rosa, CA
  • NPI 1063064715
  NPD (past)

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1700420650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 PROFESSIONAL DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033007",
            "telephone_number": "707-544-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 PROFESSIONAL DR STE 101",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033007",
            "telephone_number": "707-544-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGOMEZ",
        "first_name": "CHARIS",
        "middle_name": "MANDUJANO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Vigil, D.C.
• Rhodan Vignaud, PHYSICAL THERAPIST
• Village Charter School
• Maria de Jesus Dalia Villagomez Pulido
• Adam John Villagomez, CSAC-II
• Adrian Ventura Villalba, DC
• Josselyn Sarahy Villalobos Romero, LVN
• Jairo Osmin Villalobos Tejada
• Josseline Anai Villalobos
• Vicente Villalobos

• Addiction (Substance Use Disorder) Counselor in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.