Individual provider Active NPI

Oscar Villarreal Villasimon, LCSW

  • Clinical Social Worker
  • Palo Alto, CA
National Provider Identifier
1841415148
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS 26505 Issued in CA
Practice address
451 Lytton Ave
Palo Alto, CA 94301-1535
Phone
(714) 604-7834
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS 26505 CA Primary

Addresses

Primary practice location

451 Lytton Ave
Palo Alto, CA 94301-1535

Mailing address

451 Lytton Ave
Palo Alto, CA 94301-1535

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
I20230404002000 CA Practitioner - Clinical Social Worker 2769857739 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 26505CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Dec 10, 2022 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Dec 10, 2022 Accepting new patients

Locations

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2521 Stockton Blvd
Ste 3200
Sacramento, CA 95817
Phone (916) 734-3112

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1841415148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 LYTTON AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 LYTTON AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011535",
            "telephone_number": "714-604-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLASIMON",
        "first_name": "OSCAR",
        "middle_name": "VILLARREAL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 26505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.