Provider Demographics
NPI:1871636308
Name:VILLANUEVA, JOCETT ZABALA (D M D)
Entity Type:Individual
Prefix:DR
First Name:JOCETT
Middle Name:ZABALA
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:D M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2732
Mailing Address - Country:US
Mailing Address - Phone:925-687-9588
Mailing Address - Fax:925-680-2583
Practice Address - Street 1:3113 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2732
Practice Address - Country:US
Practice Address - Phone:925-687-9588
Practice Address - Fax:925-680-2583
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39910122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist