Individual
JOSE DE JESUS VILLA IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT
Contact information
Practice address
1963 4TH AVE, SAN DIEGO, CA 92101-2394
(619) 233-3432
Mailing address
1963 4TH AVE, SAN DIEGO, CA 92101-2394
(619) 233-3432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1498920323
CA
175T00000X
Peer Specialist
Primary
MPSS-USVMKC
CA
Other
Enumeration date
01/13/2025
Last updated
06/02/2026
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