Healthcare Provider Details

I. General information

NPI: 1932503471
Provider Name (Legal Business Name): CARINA VILLANEDA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 E VALLEY PKWY
ESCONDIDO CA
92025-3008
US

IV. Provider business mailing address

606 E VALLEY PKWY
ESCONDIDO CA
92025-3008
US

V. Phone/Fax

Practice location:
  • Phone: 760-740-8865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95023004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: