Provider Demographics
NPI:1922703115
Name:VILLAR, ANA ANDREA GARCIA
Entity Type:Individual
Prefix:
First Name:ANA ANDREA
Middle Name:GARCIA
Last Name:VILLAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 ARBOR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-5203
Mailing Address - Country:US
Mailing Address - Phone:707-567-7110
Mailing Address - Fax:
Practice Address - Street 1:746 ARBOR OAKS DR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-5203
Practice Address - Country:US
Practice Address - Phone:707-567-7110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32174167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician