Provider Demographics
NPI:1629384656
Name:JAIMES-VILLANUEVA, DENISE RAQUEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:RAQUEL
Last Name:JAIMES-VILLANUEVA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 E HALEY ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-3147
Mailing Address - Country:US
Mailing Address - Phone:805-699-6242
Mailing Address - Fax:
Practice Address - Street 1:731 E HALEY ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3147
Practice Address - Country:US
Practice Address - Phone:805-699-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY33839103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical