Healthcare Provider Details

I. General information

NPI: 1285422311
Provider Name (Legal Business Name): VILLA ANNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 04/29/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 NOVA SCOTIA DR
RIVERSIDE CA
92506-4143
US

IV. Provider business mailing address

3011 NOVA SCOTIA DR
RIVERSIDE CA
92506-4143
US

V. Phone/Fax

Practice location:
  • Phone: 951-625-1239
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE FIGUEROS
Title or Position: MANAGING MEMBER
Credential:
Phone: 951-625-1239