Healthcare Provider Details

I. General information

NPI: 1912046301
Provider Name (Legal Business Name): RACHAEL MICHELLE VILLEGAS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 EL CAMINO AVE
CARMICHAEL CA
95608-4650
US

IV. Provider business mailing address

5030 EL CAMINO AVE
CARMICHAEL CA
95608-4650
US

V. Phone/Fax

Practice location:
  • Phone: 916-609-5130
  • Fax: 916-609-5160
Mailing address:
  • Phone: 916-609-5130
  • Fax: 916-609-5160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberRPS-2006148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: