Healthcare Provider Details

I. General information

NPI: 1831035906
Provider Name (Legal Business Name): FERNANDO VILLEGAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WALNUT ST
RED BLUFF CA
96080-3611
US

IV. Provider business mailing address

818 MAIN ST
RED BLUFF CA
96080-2759
US

V. Phone/Fax

Practice location:
  • Phone: 530-527-5632
  • Fax: 530-527-0232
Mailing address:
  • Phone: 530-527-5632
  • Fax: 530-527-0232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: