Individual
KATHERINE LIZETH VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 FAIR OAKS AVE STE 300, SOUTH PASADENA, CA 91030-5805
(626) 441-4221
Mailing address
625 FAIR OAKS AVE STE 300, SOUTH PASADENA, CA 91030-5805
(626) 441-4221
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
175T00000X
Peer Specialist
Primary
—
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
05/05/2021
Last updated
11/27/2024
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