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General NPI Number Information
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NPI Number | 1346161221
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Entity Type | Individual
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Provider Name | VICTOR DAVID VILLARREAL
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Gender | Male
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Dates
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Enumeration Date | 07/24/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 3601 PACIFIC AVE
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City | STOCKTON
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State | CA
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Zip | 95211-0110
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Country | US
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Telephone | 209-946-2211
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Fax |
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Provider Business Mailing Address
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Address Line | 3907 SAN CARLOS WAY
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City | SACRAMENTO
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State | CA
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Zip | 95820-2709
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | NULL
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