Individual
ALEXIS VILLANUEVA BUENAVENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
290 S PROSPECT AVE STE A, TUSTIN, CA 92780-1523
(415) 646-6223
Mailing address
2700 PETERSON PL APT 48C, COSTA MESA, CA 92626-5370
(213) 400-3002
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
Y7143218
CA
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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