Individual
MR. JESSIE SABAS VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PRIMARY CAREGIVER
Contact information
Practice address
94-326 HENE ST, WAIPAHU, HI 96797-1301
(808) 676-9418
(808) 676-9418
Mailing address
94-326 HENE ST, WAIPAHU, HI 96797-1301
(808) 676-9418
(808) 676-9418
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HI081013513
HI
Other
Enumeration date
07/31/2012
Last updated
07/31/2012
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