MEDICARE: MR. VINCENT ANDREW VILLARUZ MSN, RN, CCRN, PHN

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	363LA2100X	Acute Care Nurse Practitioner	95142817	CA
2	363L00000X	Nurse Practitioner	95142817	CA

General Provider Information

NPI Number	:	1134062227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VINCENT ANDREW VILLARUZ MSN, RN, CCRN, PHN

Provider Business Mailing Address
First Line	:	2950 W LYNROSE DR APT B4
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3954
Country	:	US
Telephone Number	:	858-243-9016
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 W LYNROSE DR APT B4
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92804-3954
Country	:	US
Telephone Number	:	858-243-9016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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