Individual
KEVIN LOZARES VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
16950 VIA TAZON, SAN DIEGO, CA 92127-1607
(800) 926-8273
Mailing address
FILE 57326, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50796
CA
Other
Enumeration date
10/17/2020
Last updated
08/29/2024
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