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NPI Code Detail

MEDICARE: RAQUEL VILLA

MEDICARE: RAQUEL VILLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistIMF 43424CA

General Provider Information

NPI Number : 1023155140
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAQUEL VILLA
Provider Business Mailing Address
First Line : 825 E 3RD ST
Second Line :
City : CALEXICO
State : CA
Zip : 92231-3034
Country : US
Telephone Number : 760-357-3361
Fax Number :
Provider Business Practice Location Address
First Line : 202 N 8TH ST
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-2302
Country : US
Telephone Number : 760-482-4075
Fax Number : 760-482-2985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/08/2007

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Directions to “ RAQUEL VILLA ” Practice Location

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