Maria de Jesus Dalia Villagomez Pulido

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

142146 Issued in CA

Practice address

2225 Challenger Way
Santa Rosa, CA 95407-5441

Phone

(707) 576-8181

Fax

(707) 565-5183

NPI assigned

Jun 14, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Individual'S Now, Inc

  dba Social Advocates for Youth - Tamayo Village

  • Case Management Agency
  • Santa Rosa, CA
  • NPI 1942328869
  NPD (past)

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1982334710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075441",
            "telephone_number": "707-576-8181",
            "fax_number": "707-565-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075441",
            "telephone_number": "707-576-8181",
            "fax_number": "707-565-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAGOMEZ PULIDO",
        "first_name": "MARIA DE JESUS",
        "middle_name": "DALIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "142146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsty Hale Viera, PSY.D.
• Eric Keoni Vierra, O.D.
• Monica Vigil, D.C.
• Rhodan Vignaud, PHYSICAL THERAPIST
• Village Charter School
• Adam John Villagomez, CSAC-II
• Charis Mandujano Villagomez
• Adrian Ventura Villalba, DC
• Josselyn Sarahy Villalobos Romero, LVN
• Jairo Osmin Villalobos Tejada

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.