Individual provider Active NPI

Mayra Alejandra Villa I, MSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1881915767
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
78499 Issued in CA
Practice address
333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone
(213) 241-3841
Fax
(213) 241-3305
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Mental Health Counselor 101YM0800X
Rehabilitation Practitioner 225400000X
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 78499 CA Primary

Addresses

Primary practice location

333 S Beaudry Ave
Los Angeles, CA 90017-1466

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

Other practice location 1

12510 Van Nuys Blvd Ste 201
Pacoima, CA 91331
Phone (626) 395-7100

Other practice location 2

12510 Van Nuys Blvd Ste 201
Pacoima, CA 91331
Phone (626) 395-7100

Other practice location 3

15339 Saticoy St
Van Nuys, CA 91406
Phone (818) 267-2600 ext. 2709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
78499CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1881915767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12510 Van Nuys Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Pacoima",
            "state": "CA",
            "postal_code": "91331",
            "country_code": "US",
            "telephone_number": "626-395-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12510 Van Nuys Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Pacoima",
            "state": "CA",
            "postal_code": "91331",
            "country_code": "US",
            "telephone_number": "626-395-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15339 Saticoy St",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "91406",
            "country_code": "US",
            "telephone_number": "818-267-2600 x2709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLA",
        "first_name": "MAYRA",
        "middle_name": "ALEJANDRA",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "78499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.