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General NPI Number Information
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NPI Number | 1568582609
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Entity Type | Individual
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Provider Name | DOLORES VILLANUEVA LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 601 S GLENOAKS BLVD SUITE 200
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City | BURBANK
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State | CA
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Zip | 91502-1474
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Country | US
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Telephone | 818-732-0378
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Fax |
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Provider Business Mailing Address
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Address Line | 7407 DONNA AVE
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City | RESEDA
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State | CA
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Zip | 91335-2508
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Country | US
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Telephone | 818-732-0378
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW 19521
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 26466
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License Number State | CA
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