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NPI Code Detail

MEDICARE: MR. ALEXIS MONTOYA VILLALPANDO M.S. PSYCHOLOGY

MEDICARE: MR. ALEXIS MONTOYA VILLALPANDO M.S. PSYCHOLOGY
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
1103K00000XBehavior Analyst1-21-51181CA

General Provider Information

NPI Number : 1043711195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALEXIS MONTOYA VILLALPANDO M.S. PSYCHOLOGY
Provider Business Mailing Address
First Line : 2885 PIXIE DR
Second Line :
City : STOCKTON
State : CA
Zip : 95203-1115
Country : US
Telephone Number : 209-235-7068
Fax Number :
Provider Business Practice Location Address
First Line : 1141 LEVER BLVD
Second Line :
City : STOCKTON
State : CA
Zip : 95206-2855
Country : US
Telephone Number : 209-872-6091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2018
Last Update Date : 12/22/2022

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