Healthcare Provider Details

I. General information

NPI: 1932966892
Provider Name (Legal Business Name): ANNETTE DOREEN VILLACARTE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNETTE DOREEN RAMOS

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 MT DIABLO BLVD
WALNUT CREEK CA
94596-4517
US

IV. Provider business mailing address

2810 RUTHERFORD CT
LIVERMORE CA
94550-7341
US

V. Phone/Fax

Practice location:
  • Phone: 925-266-3709
  • Fax:
Mailing address:
  • Phone: 925-922-3805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95028671
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: