Individual
ANTHONY VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDRC
Contact information
Practice address
8086 ORANGE AVE, FAIR OAKS, CA 95628-5941
(888) 629-6707
Mailing address
20271 SW BIRCH ST, NEWPORT BEACH, CA 92660-1752
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12469
CA
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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