Individual
JORGE ALBERTO VILLALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
78900 AVENUE 47 STE 105, LA QUINTA, CA 92253-2070
(760) 625-0951
(760) 564-5049
Mailing address
78900 AVENUE 47 STE 105, LA QUINTA, CA 92253-2070
(760) 625-0951
(760) 564-5049
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
02/09/2017
Last updated
01/03/2024
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