Provider Demographics
NPI:1518318872
Name:VILLA, BLANCA YVETTE (ASW)
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:YVETTE
Last Name:VILLA
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W CAMPBELL AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1526
Mailing Address - Country:US
Mailing Address - Phone:408-871-4917
Mailing Address - Fax:
Practice Address - Street 1:1600 W CAMPBELL AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1526
Practice Address - Country:US
Practice Address - Phone:408-871-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor