Provider Demographics
NPI:1467076083
Name:VILLARREAL, CATARINA MERCEDES (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:CATARINA
Middle Name:MERCEDES
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:CATARINA
Other - Middle Name:MERCEDES
Other - Last Name:LARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1610 N SANTA FE AVE APT 38
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-2009
Mailing Address - Country:US
Mailing Address - Phone:210-744-5068
Mailing Address - Fax:
Practice Address - Street 1:1610 N SANTA FE AVE APT 38
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-2009
Practice Address - Country:US
Practice Address - Phone:210-744-5068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist