Individual
MR. JOHNNY VILLANUEVA AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
565 KERN ST, SHAFTER, CA 93263-2133
(661) 746-4937
Mailing address
403 BRIGHTSTONE DR, BAKERSFIELD, CA 93312-7032
(661) 333-4997
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
536811
CA
363L00000X
Nurse Practitioner
Primary
95018599
CA
Other
Enumeration date
11/21/2007
Last updated
12/29/2021
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