Healthcare Provider Details

I. General information

NPI: 1063357374
Provider Name (Legal Business Name): GABRIELA RENEE VILLANUEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CITADEL DR E
COLORADO SPRINGS CO
80909-5314
US

IV. Provider business mailing address

5850 WELKIN CIR APT 402
COLORADO SPRINGS CO
80917-1458
US

V. Phone/Fax

Practice location:
  • Phone: 720-706-3396
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: