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NPI Code Detail

MEDICARE: MS. JANIRA VILLANUEVA MSW

MEDICARE: MS. JANIRA VILLANUEVA MSW
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
11041C0700XClinical Social WorkerCA

General Provider Information

NPI Number : 1851425979
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANIRA VILLANUEVA MSW
Provider Business Mailing Address
First Line : 4940 W 99TH ST
Second Line :
City : INGLEWOOD
State : CA
Zip : 90301-3612
Country : US
Telephone Number : 310-462-0123
Fax Number :
Provider Business Practice Location Address
First Line : 838 E 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90021-1028
Country : US
Telephone Number : 213-623-8446
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/08/2007

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