Active NPI
Cristina Villicana, ACSW
- Clinical Social Worker
- Tustin, CA
National Provider Identifier
1932816675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 111695
- Practice address
- 14642 Newport Ave Ste 200
Tustin, CA 92780-6058 - Phone
- (714) 247-0300
- Fax
- (714) 259-1598
- NPI assigned
- Nov 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 111695 | CA | Primary |
Addresses
Primary practice location
14642 Newport Ave Ste 200
Tustin, CA 92780-6058
Mailing address
14642 Newport Ave Ste 300
Tustin, CA 92780-6059
Phone (714) 247-0300
Other practice location 1
947 S Anaheim Blvd Ste 260
Anaheim, CA 92805-5591
Phone (714) 247-0300
Other practice location 2
1 Hope Dr
Tustin, CA 92782-0221
Phone (714) 247-0300
Other practice location 3
1100B N Tustin Ave Ste A
Santa Ana, CA 92705-3505
Phone (714) 247-0300
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
| License | State | Type | Specialty |
|---|---|---|---|
| 111695 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667347200000",
"number": "1932816675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14642 NEWPORT AVE STE 300",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927806059",
"telephone_number": "714-247-0300",
"fax_number": "714-259-1598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14642 NEWPORT AVE STE 200",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927806058",
"telephone_number": "714-247-0300",
"fax_number": "714-259-1598"
}
],
"practiceLocations": [
{
"address_1": "947 S Anaheim Blvd Ste 260",
"address_purpose": "LOCATION",
"city": "Anaheim",
"state": "CA",
"postal_code": "928055591",
"country_code": "US",
"telephone_number": "714-247-0300",
"fax_number": "714-259-1598",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Hope Dr",
"address_purpose": "LOCATION",
"city": "Tustin",
"state": "CA",
"postal_code": "927820221",
"country_code": "US",
"telephone_number": "714-247-0300",
"fax_number": "714-259-1598",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100B N Tustin Ave Ste A",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927053505",
"country_code": "US",
"telephone_number": "714-247-0300",
"fax_number": "714-259-1598",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VILLICANA",
"first_name": "CRISTINA",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-02",
"last_updated": "2022-11-02",
"certification_date": "2022-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "111695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.