MEDICARE: EARL VILLORENTE

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
1	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	86506	CA

General Provider Information

NPI Number	:	1982037750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EARL VILLORENTE

Provider Business Mailing Address
First Line	:	2419 UNWIN CT
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-5254
Country	:	US
Telephone Number	:	650-208-6510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 UNWIN CT
Second Line	:
City	:	SOUTH SAN FRANCISCO
State	:	CA
Zip	:	94080-5254
Country	:	US
Telephone Number	:	650-208-6510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2013
Last Update Date	:	04/14/2023

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Directions to “ EARL VILLORENTE ” Practice Location

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