Healthcare Provider Details

I. General information

NPI: 1437062650
Provider Name (Legal Business Name): GIOVANNI VILLEGAS DO PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BROCKTON AVE
RIVERSIDE CA
92506
US

IV. Provider business mailing address

30767 GATEWAY PL # 556
RANCHO MISSION VIEJO CA
92694-1856
US

V. Phone/Fax

Practice location:
  • Phone: 949-427-8829
  • Fax:
Mailing address:
  • Phone: 949-427-8829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. GIOVANNI VILLEGAS
Title or Position: PSYCHIATRIST
Credential: DO
Phone: 949-427-8829