MEDICARE: ESMERALDA VILLEGAS

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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1235990458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESMERALDA VILLEGAS

Provider Business Mailing Address
First Line	:	1113 DAFFODIL ST
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92882-5819
Country	:	US
Telephone Number	:	195-183-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	6221 ROUNER DR
Second Line	:
City	:	JURUPA VALLEY
State	:	CA
Zip	:	92509-1736
Country	:	US
Telephone Number	:	951-833-3310
Fax Number	:

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

Provider Enumeration Date	:	01/16/2024
Last Update Date	:	01/16/2024

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Directions to “ ESMERALDA VILLEGAS ” Practice Location

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