Individual provider Active NPI

Daniel Ricardo Villanueva, LMFT

  • Marriage & Family Therapist
  • Pomona, CA
National Provider Identifier
1972168763
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
129674 Issued in CA
Practice address
790 E Bonita Ave
Pomona, CA 91767-1906
Phone
(909) 625-7207
NPI assigned
May 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 108291 CA
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 129674 CA Primary

Addresses

Primary practice location

790 E Bonita Ave
Pomona, CA 91767-1906

Mailing address

12223 Highland Ave # 106-354
Rancho Cucamonga, CA 91739-2574
Phone (909) 293-9265

Other practice location 1

232 Harrison Ave Ste H
Claremont, CA 91711-4323
Phone (909) 293-9265

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

LicenseStateTypeSpecialty
108291CAMDMental Health Counselor
129674CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Villanueva Therapy and Wellness Group Inc. Marriage & Family Therapist CurrentSince May 12, 2024 Accepting new patients

Locations

8291 Utica Ave
Ste 102
Rancho Cucamonga, CA 91730
Phone (909) 727-2577

12223 Highland Ave
#106354
Rancho Cucamonga, CA 91739

Organizations & group practices 1

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": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1972168763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12223 HIGHLAND AVE # 106-354",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917392574",
            "telephone_number": "909-293-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 E BONITA AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671906",
            "telephone_number": "909-625-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 Harrison Ave Ste H",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "CA",
            "postal_code": "917114323",
            "country_code": "US",
            "telephone_number": "909-293-9265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "DANIEL",
        "middle_name": "RICARDO",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "108291",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "129674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.