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General NPI Number Information
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NPI Number | 1225879026
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Entity Type | Individual
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Provider Name | NICOLE FELICIA VILLARREAL
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 343 S MOORPARK RD STE A
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1008
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Country | US
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Telephone | 818-865-8500
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Fax | 818-865-8022
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Provider Business Mailing Address
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Address Line | 4263 TIERRA REJADA RD # 214
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City | MOORPARK
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State | CA
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Zip | 93021-3772
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Country | US
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Telephone | 805-551-1919
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95028191
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License Number State | CA
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