Active NPI
Maryah Villavicencio
- Mental Health Counselor
- Sacramento, CA
National Provider Identifier
1982359824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 126931
- Practice address
- 2108 N St Ste 5934
Sacramento, CA 95816-5712 - Phone
- (626) 765-5145
- NPI assigned
- Feb 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 126931 | CA | Primary |
Addresses
Primary practice location
2108 N St Ste 5934
Sacramento, CA 95816-5712
Mailing address
14223 Galega CT
Beaumont, CA 92223-6313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126931 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737763200000",
"number": "1982359824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14223 GALEGA CT",
"city": "BEAUMONT",
"state": "CA",
"postal_code": "922236313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 N ST STE 5934",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165712",
"telephone_number": "626-765-5145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLAVICENCIO",
"first_name": "MARYAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-18",
"last_updated": "2025-01-25",
"certification_date": "2025-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "126931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.