Individual
HAZEL VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16260 VENTURA BLVD STE 600, ENCINO, CA 91436-4604
(818) 986-1977
Mailing address
6667 WILBUR AVE UNIT 36, RESEDA, CA 91335-5170
(818) 648-9106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9807
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
953995050
—
CA
Enumeration date
06/30/2016
Last updated
06/30/2016
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