Provider Demographics
NPI:1245616390
Name:PAPACOSTAS VILLEGAS, ARIADNE (BACHELOR OF PSYCHOLO)
Entity Type:Individual
Prefix:MISS
First Name:ARIADNE
Middle Name:
Last Name:PAPACOSTAS VILLEGAS
Suffix:
Gender:F
Credentials:BACHELOR OF PSYCHOLO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 OAK STREET UNIT 10
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117
Mailing Address - Country:US
Mailing Address - Phone:415-802-4264
Mailing Address - Fax:
Practice Address - Street 1:2919 MISSION STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-229-0050
Practice Address - Fax:415-647-3662
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program