Healthcare Provider Details

I. General information

NPI: 1427977594
Provider Name (Legal Business Name): NAILEAH VILLEGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5308 FAIRFAX RD APT C
BAKERSFIELD CA
93306-2874
US

IV. Provider business mailing address

5308 FAIRFAX RD APT C
BAKERSFIELD CA
93306-2874
US

V. Phone/Fax

Practice location:
  • Phone: 661-612-4538
  • Fax:
Mailing address:
  • Phone: 661-612-4538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberY2698935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: