Individual provider Active NPI

Suenia Yvonne Villa, LCSW

  • Clinical Social Worker
  • Hollister, CA
National Provider Identifier
1720531585
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW71155 Issued in CA
Practice address
30 Azul CT
Hollister, CA 95023-3202
Phone
(408) 642-9194
NPI assigned
Jul 28, 2016
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW71155 CA Primary
Clinical Social Worker 1041C0700X LW61024842 WA

Addresses

Primary practice location

30 Azul CT
Hollister, CA 95023-3202

Mailing address

30 Azul CT
Hollister, CA 95023-3202
Phone (408) 642-9194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200603002007 CA Practitioner - Clinical Social Worker 1951722768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Community HealthGroup PAC ID 1658349824, 106 clinicians

Practice addresses (Care Compare)

1650 S White Rd
San Jose, CA 95127-4758
Phone (408) 928-5250

5504 Monterey Hwy
San Jose, CA 95138-1529
Phone (408) 729-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW71155CAMDClinical Social Worker
LW61024842WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Health Center of Santa Clara Valley CurrentSince Apr 29, 2020 Accepting new patients
Indian Health Center of Santa Clara Valley Current Accepting new patients
Bay Area Community Health CurrentSince Apr 3, 2025 Accepting new patients
Bay Area Community Health CurrentSince Apr 3, 2025 Accepting new patients
Indian Health Center of Santa Clara Valley CurrentSince Apr 29, 2020 Accepting new patients
Mark David Levine, MD Burlingame PC PastSince Aug 1, 2022 Accepting new patients

Locations

1860 Mowry Ave
Ste 400
Fremont, CA 94538
Phone (510) 284-4100

39500 Liberty St
Fremont, CA 94538
Phone (510) 770-8133

40910 Fremont Blvd
Fremont, CA 94538
Phone (510) 770-8133

1860 Mowry Ave
Fremont, CA 94538
Phone (510) 284-4140

9460 No Name Uno
Ste 110
Gilroy, CA 95020
Phone (408) 797-2500

1642 E Capitol Expy
San Jose, CA 95121
Phone (408) 270-0112

1333 Meridian Ave
San Jose, CA 95125

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1720531585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AZUL CT",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233202",
            "telephone_number": "408-642-9194",
            "fax_number": "206-326-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 AZUL CT",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233202",
            "telephone_number": "408-642-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "SUENIA",
        "middle_name": "YVONNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW71155",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61024842",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollister, CA

Sources for this page

Verify at the official NPI Registry.