Individual
CRISTAN DALE VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9089 CLAIREMONT MESA BLVD, STE 200, SAN DIEGO, CA 92123-1225
(858) 264-4677
Mailing address
9089 CLAIREMONT MESA BLVD, STE 200, SAN DIEGO, CA 92123-1225
(858) 264-4677
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103528349
CIGNA
CA
Enumeration date
05/04/2018
Last updated
05/04/2018
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