Provider Demographics
NPI:1134109606
Name:VILLAFRANCA-JOHNSON, ANDREA LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LYNNE
Last Name:VILLAFRANCA-JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:LYNNE
Other - Last Name:VILLAFRANCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:322 CERNON ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4502
Mailing Address - Country:US
Mailing Address - Phone:707-469-0308
Mailing Address - Fax:707-469-0142
Practice Address - Street 1:322 CERNON ST
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4502
Practice Address - Country:US
Practice Address - Phone:707-469-0308
Practice Address - Fax:707-469-0142
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0291790Medicare UPIN