MEDICARE: MS. HILDA VILLANUEVA MS, LMFT

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	106H00000X	Marriage & Family Therapist	IMF54040	CA
2	106H00000X	Marriage & Family Therapist	53087	CA

General Provider Information

NPI Number	:	1386827483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HILDA VILLANUEVA MS, LMFT

Provider Business Mailing Address
First Line	:	350 90TH ST
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-1879
Country	:	US
Telephone Number	:	650-301-8650
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 90TH ST
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94015-1879
Country	:	US
Telephone Number	:	650-301-8650
Fax Number	:

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

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	04/13/2021

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