Active NPI
Jessica Villarreal
- Clinical Social Worker
- Indio, CA
National Provider Identifier
1760864847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 98209
- Practice address
- 82934 Civic Center Dr
Indio, CA 92201-4308 - Phone
- (760) 477-0733
- NPI assigned
- Jun 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | 98209 | CA | Primary |
Addresses
Primary practice location
82934 Civic Center Dr
Indio, CA 92201-4308
Mailing address
49905 Avenida de Platina
Coachella, CA 92236-1340
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
47470 Van Buren St
Indio, CA 92201-7139
Phone (909) 382-7100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98209 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sac Health System | Current | Accepting new patients |
Locations
1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146
Organizations & group practices 1
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.
-
dba SAC Arrowhead
- Federally Qualified Health Center (FQHC)
- San Bernardino, CA
- NPI 1013935923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1760864847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49905 AVENIDA DE PLATINA",
"city": "COACHELLA",
"state": "CA",
"postal_code": "922361340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82934 CIVIC CENTER DR",
"city": "INDIO",
"state": "CA",
"postal_code": "922014308",
"telephone_number": "760-477-0733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLARREAL",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-24",
"last_updated": "2022-07-14",
"certification_date": "2022-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "98209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.