Individual
JACQUELINE VILLASENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
660 E LOS ANGELES AVE STE B2, SIMI VALLEY, CA 93065-1884
(805) 522-1844
Mailing address
1734 AGNEW ST, SIMI VALLEY, CA 93065-2141
(805) 791-6928
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
709806
CA
Other
Enumeration date
04/12/2020
Last updated
04/12/2020
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