MEDICARE: MARIA ELENA 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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1659561561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA ELENA VILLANUEVA

Provider Business Mailing Address
First Line	:	8827 BIRCHLEAF AVE
Second Line	:
City	:	DOWNEY
State	:	CA
Zip	:	90240-2304
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 W VICTORIA ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-2162
Country	:	US
Telephone Number	:	310-603-1050
Fax Number	:

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

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	07/26/2007

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Directions to “ MARIA ELENA VILLANUEVA ” Practice Location

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