MEDICARE: BARRETT VILLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1013833292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRETT VILLA

Provider Business Mailing Address
First Line	:	1601 GARRETSON AVE
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-2429
Country	:	US
Telephone Number	:	951-266-6299
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 GARRETSON AVE
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92879-2429
Country	:	US
Telephone Number	:	951-266-6299
Fax Number	:

Authorized Official
Title or Position	:	LICENSEE REPRESENTATIVE
Name	:	STEVEN C BARRETT
Credential	:
Telephone Number	:	951-707-5882

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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Directions to “BARRETT VILLA ” Practice Location

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