Provider Demographics
NPI:1598223638
Name:VILLARICO, YOLANDA VILLADOZ
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:VILLADOZ
Last Name:VILLARICO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9175 TITAN HILL CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4955
Mailing Address - Country:US
Mailing Address - Phone:702-802-3585
Mailing Address - Fax:
Practice Address - Street 1:9175 TITAN HILL CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4955
Practice Address - Country:US
Practice Address - Phone:702-802-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV53485800001Medicaid