Provider Demographics
NPI:1790205227
Name:VILLARREAL, ESMERALDA V (BEHAVIORAL HEALTH)
Entity Type:Individual
Prefix:MRS
First Name:ESMERALDA
Middle Name:V
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:BEHAVIORAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 PUTERBAUGH RD
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-8200
Mailing Address - Country:US
Mailing Address - Phone:509-203-0953
Mailing Address - Fax:
Practice Address - Street 1:1950 KEENE RD BLDG L
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-7752
Practice Address - Country:US
Practice Address - Phone:808-284-7225
Practice Address - Fax:858-521-8173
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor