Individual
AILEEN GAIL VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5425 POMONA BLVD, LOS ANGELES, CA 90022-1716
(323) 728-0411
(323) 890-8761
Mailing address
2461 WAGNER ST, UNIT 8, PASADENA, CA 91107-2565
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7991
CA
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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