Athena Villasenor Taylan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A066587 Issued in CA

Practice address

768 Mountain Ranch Rd
San Andreas, CA 95249-9707

Phone

(209) 736-0813

Fax

(209) 736-9088

NPI assigned

Feb 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Athena Silva Villasenor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mark Twain Medical Center

  • Rural Health Clinic/Center
  • San Andreas, CA
  • NPI 1205002938
  NPD (past)
• Mark Twain Medical Center

  • Critical Access Hospital
  • San Andreas, CA
  • NPI 1508968819
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871629477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4694 GRESHAM DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627624",
            "telephone_number": "916-941-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499707",
            "telephone_number": "209-736-0813",
            "fax_number": "209-736-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLAN",
        "first_name": "ATHENA",
        "middle_name": "VILLASENOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A066587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATHENA",
            "last_name": "VILLASENOR",
            "middle_name": "SILVA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Souza, B.A.
• Stacy Elias Doula
• Sarah Mae Staudy
• Leandra Steenkamp
• Stephanie Dorsey Licensed Clinical Social Worker PC
• Anne Marie Taylor
• Thanh Pham DDS Dental Corporation
• Christa Thompson, LCSW
• Danny William Thompson
• Elizabeth Thompson

• Pediatrics Physician in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.