MEDICARE: JACKIE GISELLE VILLARREAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	APCC161660	CA

General Provider Information

NPI Number	:	1619727088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKIE GISELLE VILLARREAL

Provider Business Mailing Address
First Line	:	40825 AMADOR DR
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92203-3874
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	83912 AVENUE 45
Second Line	:
City	:	INDIO
State	:	CA
Zip	:	92201-7351
Country	:	US
Telephone Number	:	760-347-0754
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2024
Last Update Date	:	01/14/2026

Similar Medicare Providers

1437038908 — BEATRIZ ADRIANA GONZALEZ SUBSTANCE ABUSE
Practice Location Address:

83912 AVENUE 45 STE A
INDIO, CA
92201-7351

Practice Phone: 760-347-0754
Practice Fax:

1629111398 — SMS TRANSPORTATION
Practice Location Address:

83912 AVENUE 45 , SUITE 10
INDIO, CA
92201-7351

Practice Phone: 760-347-3900
Practice Fax: 760-346-7052

1306323811 — JESSICA CABALLERO
Practice Location Address:

83912 AVENUE 45
INDIO, CA
92201-7351

Practice Phone: 760-347-0754
Practice Fax:

1811695588 — MICHELLE RODARTE RADT
Practice Location Address:

83912 AVENUE 45
INDIO, CA
92201-7351

Practice Phone: 442-933-1753
Practice Fax:

1902133572 — MR. BRIAN DAVID DEOLIVEIRA LMFT
Practice Location Address:

44199 MONROE ST
INDIO, CA
92201-3096

Practice Phone: 951-731-8181
Practice Fax:

1568320117 — REBECCA PHILLIPS PT
Practice Location Address:

81557 DR CARREON BLVD STE C4
INDIO, CA
92201-5562

Practice Phone: 760-347-6195
Practice Fax: 760-347-2849

Directions to “ JACKIE GISELLE VILLARREAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.