Individual
ANGELICA VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1825 DERBY ST APT D, BERKELEY, CA 94703-1967
(862) 249-3596
Mailing address
1825 DERBY ST APT D, BERKELEY, CA 94703-1967
(862) 249-3596
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6074
CA
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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