Individual
MR. RAYMOND A VILLAVERDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4140 JADE ST, SUITE 100, CAPITOLA, CA 95010-3956
(831) 475-4344
(831) 475-4344
Mailing address
4140 JADE ST, SUITE 100, CAPITOLA, CA 95010-3956
(831) 475-4344
(831) 475-4344
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA21732
CA
364SM0705X
Medical-Surgical Clinical Nurse Specialist
085-001011
IL
Other
Enumeration date
07/19/2005
Last updated
05/22/2020
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