Healthcare Provider Details

I. General information

NPI: 1851244875
Provider Name (Legal Business Name): KAITLYN M VILLICANA-RAMIREZ ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ANTELOPE BLVD
RED BLUFF CA
96080-2807
US

IV. Provider business mailing address

20 ANTELOPE BLVD
RED BLUFF CA
96080-2807
US

V. Phone/Fax

Practice location:
  • Phone: 530-567-7600
  • Fax: 530-727-9094
Mailing address:
  • Phone: 530-567-7600
  • Fax: 530-727-9094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number133862
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: