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General NPI Number Information
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NPI Number | 1043748437
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Entity Type | Individual
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Provider Name | MRS. JULIA FAY VILLARREAL
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Gender | Female
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 4470 W SUNSET BLVD STE 107
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City | LOS ANGELES
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State | CA
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Zip | 90027-6309
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Country | US
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Telephone | 916-919-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 7273 14TH AVE #120B
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City | SACRAMENTO
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State | CA
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Zip | 95820
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Country | US
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Telephone | 210-739-3247
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 107363
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License Number State | CA
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