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Individual
JONATHAN VILLICANA
Active
Individual
JONATHAN VILLICANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34428
CA
103TH0004X
Health Psychologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2022
Last updated
07/01/2024
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