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General NPI Number Information
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NPI Number | 1720946163
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Entity Type | Individual
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Provider Name | CESAR GUSTAVO VILLA PMHNP
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Gender | Male
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 618 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19133-2227
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Country | US
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Telephone | 215-229-8857
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Fax | 215-229-0654
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Provider Business Mailing Address
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Address Line | 618 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19133-2227
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Country | US
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Telephone | 215-229-8857
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Fax | 215-229-0654
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP034981
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License Number State | PA
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