Individual
BERENICE VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 280-4213
(619) 906-4564
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 280-4213
(619) 906-4564
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95002188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95002188
LICENSE
CA
Enumeration date
03/23/2015
Last updated
03/04/2019
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