MEDICARE: RONNIE COMIA VILLANUEVA

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	163WR0006X	Registered Nurse First Assistant	95183019	CA

General Provider Information

NPI Number	:	1245818921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONNIE COMIA VILLANUEVA

Provider Business Mailing Address
First Line	:	17081 PISTACHE DR
Second Line	:
City	:	MORGAN HILL
State	:	CA
Zip	:	95037-7246
Country	:	US
Telephone Number	:	408-823-2070
Fax Number	:

Provider Business Practice Location Address
First Line	:	17081 PISTACHE DR
Second Line	:
City	:	MORGAN HILL
State	:	CA
Zip	:	95037-7246
Country	:	US
Telephone Number	:	408-823-2070
Fax Number	:

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

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	03/13/2026

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Directions to “ RONNIE COMIA VILLANUEVA ” Practice Location

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