Provider Demographics
NPI:1609285931
Name:VILLANUEVA, CRISTINA (MS)
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4641 OLD CHENEY RD
Mailing Address - Street 2:APT. 22
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2869
Mailing Address - Country:US
Mailing Address - Phone:817-994-1197
Mailing Address - Fax:
Practice Address - Street 1:3700 SHERIDAN BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-6100
Practice Address - Country:US
Practice Address - Phone:402-489-1834
Practice Address - Fax:405-489-2046
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health