Healthcare Provider Details

I. General information

NPI: 1841195070
Provider Name (Legal Business Name): DIEGO ANTONIO VILLARROEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 S SAN ANTONIO RD
LOS ALTOS CA
94022-3751
US

IV. Provider business mailing address

241 S SAN ANTONIO RD
LOS ALTOS CA
94022-3751
US

V. Phone/Fax

Practice location:
  • Phone: 650-938-3600
  • Fax: 650-332-3927
Mailing address:
  • Phone: 650-938-3600
  • Fax: 650-332-3927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: