Individual provider Active NPI

Angelica Marie Villa, O.D.

  • Optometrist
  • Chula Vista, CA
National Provider Identifier
1962544965
Registry record updated Mar 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10561T Issued in CA
Practice address
523 Telegraph Canyon Rd
Chula Vista, CA 91910-6436
Phone
(619) 482-2020
Fax
(619) 482-2671
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10561T CA Primary

Addresses

Primary practice location

523 Telegraph Canyon Rd
Chula Vista, CA 91910-6436

Mailing address

523 Telegraph Canyon Rd
Chula Vista, CA 91910-6436
Phone (619) 482-2020

Other identifiers 1

IdentifierTypeStateIssuer
1962544965MedicaidCA

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
I20120912000434 CA Practitioner - Optometry 4688822943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villa Optometry IncGroup PAC ID 3577848027, 2 clinicians

Practice addresses (Care Compare)

523 Telegraph Canyon Rd
Chula Vista, CA 91910-6436
Phone (619) 482-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10561TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
W Joseph Garvin OD Optometric Corporation CurrentSince Mar 12, 2018 Accepting new patients

Locations

531 Telegraph Canyon Rd
Chula Vista, CA 91910
Phone (619) 482-2020

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774137600000",
    "number": "1962544965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 TELEGRAPH CANYON RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919106436",
            "telephone_number": "619-482-2020",
            "fax_number": "619-482-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 TELEGRAPH CANYON RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919106436",
            "telephone_number": "619-482-2020",
            "fax_number": "619-482-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "ANGELICA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2026-03-22",
        "certification_date": "2026-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10561T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962544965",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.