Individual
BRIANDA VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW 101918
Contact information
Practice address
801 CORPORATE CENTER DR STE 202, POMONA, CA 91768-2628
(909) 766-7060
(909) 992-3177
Mailing address
PO BOX 1075, ONTARIO, CA 91762-0075
(909) 247-4651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101918
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1943
MEDICAL
CA
Enumeration date
07/28/2016
Last updated
12/06/2021
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