Provider Demographics
NPI:1033399225
Name:VILLALPANDO, ROSA MARIA (PSYD)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:VILLALPANDO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9911 PARAMOUNT BLVD # 190
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-3856
Mailing Address - Country:US
Mailing Address - Phone:213-309-5016
Mailing Address - Fax:
Practice Address - Street 1:9911 PARAMOUNT BLVD # 190
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-3856
Practice Address - Country:US
Practice Address - Phone:213-309-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21626103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY21626OtherPSY21626