Healthcare Provider Details

I. General information

NPI: 1437834603
Provider Name (Legal Business Name): NAPOLEON ESCALANTE VILLASIS JR FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 N. SAN JACINTO ST.
HEMET CA
92543
US

IV. Provider business mailing address

31252 BLACK MAPLE DR
TEMECULA CA
92592
US

V. Phone/Fax

Practice location:
  • Phone: 951-665-1100
  • Fax:
Mailing address:
  • Phone: 951-216-5590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23560
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: