Individual provider Active NPI

Melanie Aguilo Vizon, RN. NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1952559262
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP17396 Issued in CA
Practice address
1061 Tierra del Rey
Suite 200
Chula Vista, CA 91910-7880
Phone
(619) 498-5454
Fax
(619) 498-5455
NPI assigned
Aug 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP17396 CA Primary

Addresses

Primary practice location

1061 Tierra del Rey
Suite 200
Chula Vista, CA 91910-7880

Mailing address

PO Box 609001
San Diego, CA 92160-9001
Phone (619) 528-4600

Other names 1

  • Melanie Tongson Aguilo Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110531000733 CA Practitioner - Nurse Practitioner 9638356686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1061 Tierra del Rey
Suite 200
Chula Vista, CA 91910-7881
Phone (855) 427-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP17396CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mark David Levine, MD Burlingame PC CurrentSince Oct 25, 2024 Accepting new patients
Mark David Levine M.D. Professional Corporation Psychiatric/Mental Health CurrentSince Oct 25, 2024 Accepting new patients

Locations

6010 Hidden Valley Rd
Ste 115
Carlsbad, CA 92011
Phone (760) 797-8494

1061 Tierra del Rey
Ste 200
Chula Vista, CA 91910
Phone (619) 498-5454

4700 Spring St
Ste 220
La Mesa, CA 91942
Phone (619) 667-3380

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

Interoperability endpoints

  • Direct secure messaging: melanie.vizon.p1@direct.pcsd.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1952559262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921609001",
            "telephone_number": "619-528-4600",
            "fax_number": "619-528-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 TIERRA DEL REY",
            "address_2": "SUITE 200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107880",
            "telephone_number": "619-498-5454",
            "fax_number": "619-498-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZON",
        "first_name": "MELANIE",
        "middle_name": "AGUILO",
        "credential": "RN. NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-29",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP17396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "AGUILO",
            "middle_name": "TONGSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.