Individual
BLAINE VILLARREAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3878 RUFFIN RD, SAN DIEGO, CA 92123-1842
(619) 795-9925
Mailing address
1989 EDISON CT, CHULA VISTA, CA 91915-1459
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-24-336646
CA
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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