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NPI Code Detail

MEDICARE: LISA VILLARREAL MS, CCC-SLP

MEDICARE: LISA VILLARREAL MS, CCC-SLP
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
1235Z00000XSpeech-Language PathologistSP25739CA

General Provider Information

NPI Number : 1417812330
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA VILLARREAL MS, CCC-SLP
Provider Business Mailing Address
First Line : 774 S PLACENTIA AVE STE 100
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-6838
Country : US
Telephone Number : 714-646-8318
Fax Number : 714-455-3656
Provider Business Practice Location Address
First Line : 774 S PLACENTIA AVE STE 100
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-6838
Country : US
Telephone Number : 714-646-8318
Fax Number : 714-455-3656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2025
Last Update Date : 12/23/2025

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Directions to “ LISA VILLARREAL MS, CCC-SLP” Practice Location

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