Provider Demographics
NPI:1760094734
Name:VILLEGAS, MARIA DE JESUS (MOBILE ASSESSMENT CO)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DE JESUS
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:MOBILE ASSESSMENT CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:PAUMA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92061-0406
Mailing Address - Country:US
Mailing Address - Phone:760-749-1410
Mailing Address - Fax:760-749-5518
Practice Address - Street 1:1105 BROADWAY STE 207
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2767
Practice Address - Country:US
Practice Address - Phone:619-425-5609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174H00000XOther Service ProvidersHealth Educator