Active NPI
Monica Marie Villa, PA
- Physician Assistant
- Oakland, CA
National Provider Identifier
1952310641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18349
- Practice address
- 411 30TH St
#508
Oakland, CA 94609-3310 - Phone
- (925) 274-4950
- Fax
- (925) 274-4975
- NPI assigned
- Aug 5, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18349 | CA | Primary |
Addresses
Primary practice location
411 30TH St
#508
Oakland, CA 94609-3310
Mailing address
411 30TH St
#508
Oakland, CA 94609-3310
Phone (925) 274-4950
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18349 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affiliates in Imaging, a Medical Group Inc | Past | Accepting new patients | |
| Pacific Imaging Consultants, a Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Oakland, CA
- NPI 1083608541
-
- Diagnostic Radiology Physician
- Oakland, CA
- NPI 1265480099
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1952310641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 30TH ST",
"address_2": "#508",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093310",
"telephone_number": "925-274-4950",
"fax_number": "925-274-4975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 30TH ST",
"address_2": "#508",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093310",
"telephone_number": "925-274-4950",
"fax_number": "925-274-4975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLA",
"first_name": "MONICA",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18349",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1425 S Main St",
"city": "Walnut Creek",
"state": "CA",
"country_code": "US",
"postal_code": "945965318",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.