Provider Demographics
NPI:1043782964
Name:CENTER FOR WOMEN'S WELLNESS, LLC
Entity Type:Organization
Organization Name:CENTER FOR WOMEN'S WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-814-7000
Mailing Address - Street 1:1524 LOS ALAMOS AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-1120
Mailing Address - Country:US
Mailing Address - Phone:505-228-6154
Mailing Address - Fax:
Practice Address - Street 1:6801 JEFFERSON ST NE STE 350
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4361
Practice Address - Country:US
Practice Address - Phone:505-884-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty