MEDICARE: SONIA ESTIVAL VILA ASW

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	104100000X	Social Worker	34614	CA
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710230263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA ESTIVAL VILA ASW

Provider Business Mailing Address
First Line	:	515 WINDSOR PARK DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-4112
Country	:	US
Telephone Number	:	937-723-9881
Fax Number	:	937-723-9888

Provider Business Practice Location Address
First Line	:	515 WINDSOR PARK DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-4112
Country	:	US
Telephone Number	:	510-252-5813
Fax Number	:

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

Provider Enumeration Date	:	10/22/2012
Last Update Date	:	09/15/2025

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