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NPI Code Detail

MEDICARE: JENNALY VILLARUZ

MEDICARE: JENNALY VILLARUZ
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
1167G00000XLicensed Psychiatric Technician

General Provider Information

NPI Number : 1700731874
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNALY VILLARUZ
Provider Business Mailing Address
First Line : 2101 COURAGE DR
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2101 COURAGE DR
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number : 707-428-1131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ JENNALY VILLARUZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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