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General NPI Number Information
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NPI Number | 1669833570
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Entity Type | Organization
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Legal Business Name | MARIA GENEY VILLAVICENCIO - LMFT
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Dates
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Enumeration Date | 03/19/2016
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Last Update Date | 03/19/2016
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Provider Practice Location Address
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Address Line | 555 MIDDLEFIELD RD STE 107
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City | PALO ALTO
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State | CA
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Zip | 94301-2124
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Country | US
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Telephone | 650-353-7430
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Fax | 650-331-3517
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Provider Business Mailing Address
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Address Line | PO BOX 541
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City | REDWOOD CITY
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State | CA
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Zip | 94064-0541
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Country | US
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Telephone | 650-353-7430
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Fax | 650-331-3517
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Authorized Official
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Title or Position | LMFT
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Name | GENEY VILLAVICENCIO
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Credential |
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Telephone | 650-353-7430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 51316
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License Number State | CA
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