Provider Demographics
NPI:1093034662
Name:VILLANUEVA, ELIZABETH (LVN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:IZQUIERDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:460 W GUAVA ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-3437
Mailing Address - Country:US
Mailing Address - Phone:805-844-8666
Mailing Address - Fax:
Practice Address - Street 1:460 W GUAVA ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3437
Practice Address - Country:US
Practice Address - Phone:805-844-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 228341164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse