Individual provider Active NPI

Sharon Villa, OD

  • Optometrist
  • Walnut Creek, CA
National Provider Identifier
1962043463
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34415TLG Issued in CA
Practice address
1613 Locust St
Walnut Creek, CA 94596-4118
Phone
(925) 765-8958
NPI assigned
Oct 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34415TLG CA Primary

Addresses

Primary practice location

1613 Locust St
Walnut Creek, CA 94596-4118

Mailing address

2746 Bal Harbor LN
Hayward, CA 94545-3404
Phone (510) 754-5438

Other practice location 1

2746 Bal Harbor Ln
Hayward, CA 94545-3404
Phone (510) 754-5438

Other practice location 2

5859 Foothill Blvd
# 3
Oakland, CA 94605-1305
Phone (510) 244-5690

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111000781 CA Practitioner - Optometry 2769814938 Reassigns benefits to 1 organization
Practice locations: Oakland, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1613 Locust St
Walnut Creek, CA 94596-4118
Phone (925) 932-4362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34415CAMDGeneral Practice Dentistry
34415TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Villa Optometric Group CurrentSince Mar 29, 2021 Accepting new patients
La Clinica de la Raza Inc Current Accepting new patients

Locations

1613 Locust St
Walnut Creek, CA 94596
Phone (925) 765-8958

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.

NPI Registry JSON

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

{
    "created_epoch": "1570233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1962043463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 BAL HARBOR LN",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945453404",
            "telephone_number": "510-754-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 LOCUST ST",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945964118",
            "telephone_number": "925-765-8958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2746 Bal Harbor Ln",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945453404",
            "country_code": "US",
            "telephone_number": "510-754-5438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5859 FOOTHILL BLVD",
            "address_2": "# 3",
            "address_purpose": "LOCATION",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946051305",
            "country_code": "US",
            "telephone_number": "510-244-5690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLA",
        "first_name": "SHARON",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-05",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34415TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.