Provider Demographics
NPI:1285629873
Name:VILLA, JUDITH ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:VILLA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 BARCELONA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4501
Mailing Address - Country:US
Mailing Address - Phone:805-682-9885
Mailing Address - Fax:805-682-5503
Practice Address - Street 1:924 ANACAPA ST
Practice Address - Street 2:SUITE 2H
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2115
Practice Address - Country:US
Practice Address - Phone:805-682-9885
Practice Address - Fax:805-682-5503
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM14377106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist