Individual
DR. DIVINA THEODOSIA VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
CALIFORNIA MENS COLONY COLONY DR, SAN LUIS OBISPO, CA 93409-1953
(805) 547-7900
Mailing address
PO BOX 155, MORRO BAY, CA 93443-0155
(775) 722-2969
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY30361
CA
Other
Enumeration date
05/12/2010
Last updated
05/15/2025
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