Individual
SAMANTHA REBEKAH VILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
3117 30TH ST, SAN DIEGO, CA 92104-4505
(619) 417-6451
(478) 301-2039
Mailing address
3266 NUTMEG STREET, ATHLETIC TRAINING FACILITY, SAN DIEGO, CA 92104
(619) 282-2184
(619) 282-1203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001682
GA
Other
Enumeration date
09/09/2009
Last updated
02/02/2021
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