Provider Demographics
NPI:1609127364
Name:VILLARREAL, ROBERTA DENNETTE (DENNETTE VILLARREAL)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:DENNETTE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:DENNETTE VILLARREAL
Other - Prefix:
Other - First Name:DENNETTE
Other - Middle Name:
Other - Last Name:VILLARREAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DENNETTE VILLARREAL
Mailing Address - Street 1:7218 SERTA CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3461
Mailing Address - Country:US
Mailing Address - Phone:408-655-8358
Mailing Address - Fax:
Practice Address - Street 1:9837 FOLSOM BLVD STE F
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-856-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker