Provider Demographics
NPI:1497390876
Name:VILLAVER, NORLYNDA SARMAGO (FNP-C)
Entity Type:Individual
Prefix:
First Name:NORLYNDA
Middle Name:SARMAGO
Last Name:VILLAVER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:NORLYNDA
Other - Middle Name:ANTONIO
Other - Last Name:SARMAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1775 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-3608
Mailing Address - Country:US
Mailing Address - Phone:209-358-5611
Mailing Address - Fax:
Practice Address - Street 1:1775 3RD ST
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-3608
Practice Address - Country:US
Practice Address - Phone:209-358-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-09
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily