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NPI Code Detail

MEDICARE: KATRINA DYSTANY VILLEGAS

MEDICARE:   KATRINA DYSTANY 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
1225400000XRehabilitation Practitioner
2175T00000XPeer SpecialistCA

General Provider Information

NPI Number : 1326176454
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA DYSTANY VILLEGAS
Provider Business Mailing Address
First Line : PO BOX 1000
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93302-1000
Country : US
Telephone Number : 661-868-6601
Fax Number : 661-868-6666
Provider Business Practice Location Address
First Line : 7200 BANCROFT AVE STE 267
Second Line :
City : OAKLAND
State : CA
Zip : 94605-2408
Country : US
Telephone Number : 510-735-0864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 09/18/2025

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Directions to “ KATRINA DYSTANY VILLEGAS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.