Alexandria Therese Villanueva

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95012484 Issued in CA

Practice address

400 W 30TH St
Los Angeles, CA 90007-3320

Phone

(213) 284-3200

NPI assigned

Aug 17, 2020

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Northeast Valley Health CorporationGroup PAC ID 3173517323, 77 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: alexandria.villanuevanp.p1@direct.plannedparenthoodla.nextgenshare.com
• Direct secure messaging: alexandria.villanueva.p1@direct.nevhc.nextgenshare.com

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.

• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Van Nuys, CA
  • NPI 1629079009
  Medicare reassignment Care Compare group NPD
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • San Fernando, CA
  • NPI 1235130600
  NPD
• Northeast Valley Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santa Clarita, CA
  • NPI 1548960834
  NPD
• PC Medical Clinic Inc

  • General Practice Physician
  • Santa Clarita, CA
  • NPI 1093814113

  Family

  NPD

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1710599345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 30TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073320",
            "telephone_number": "213-282-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 30TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900073320",
            "telephone_number": "213-284-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17637 Gladesworth Ln",
            "address_purpose": "LOCATION",
            "city": "Canyon Country",
            "state": "CA",
            "postal_code": "913873809",
            "country_code": "US",
            "telephone_number": "661-993-7574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ALEXANDRIA",
        "middle_name": "THERESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100195312",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "17637 Gladesworth Ln",
            "city": "Canyon Country",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913873809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alonso Villanueva Serrano
• Sandra Villanueva-Chocoy
• Jacqueline Villanueva-Garcia
• Lisa Villanueva-Jonsson, LMFT
• Aileen Gail Villanueva, OTR
• Amy Villanueva
• Brandon Villanueva
• Carlos Villanueva
• Christina Villanueva
• Ciara Chante Villanueva, CMPSS

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.