Individual
GUADALUPE VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
903 CALLE AMANECER STE 200, SAN CLEMENTE, CA 92673-6252
(949) 388-6552
Mailing address
550 PAULARINO AVE APT M211, COSTA MESA, CA 92626-3244
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48900
CA
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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