Individual
MR. CLARITO DIMACALI VILLANUEVA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25000 AVENUE STANFORD, SANTA CLARITA, CA 91355-1224
(818) 600-2034
Mailing address
4027 YORK BLVD, LOS ANGELES, CA 90065-3720
(213) 268-5296
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
770232
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95013359
CA
Other
Enumeration date
05/06/2019
Last updated
04/29/2020
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