MEDICARE: TERRY 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
1	101YS0200X	School Counselor		CA

General Provider Information

NPI Number	:	1811858863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRY VILLEGAS

Provider Business Mailing Address
First Line	:	1111 VAN NESS AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93721-2002
Country	:	US
Telephone Number	:	559-265-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	33326 LODGE RD
Second Line	:
City	:	TOLLHOUSE
State	:	CA
Zip	:	93667-9644
Country	:	US
Telephone Number	:	559-855-8311
Fax Number	:

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

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	11/19/2025

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Directions to “ TERRY VILLEGAS ” Practice Location

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