Provider Demographics
NPI:1982182499
Name:VILLARREAL, MILAGROS JACQUELINE (ACSW)
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:JACQUELINE
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3656 GARNET ST APT 224
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-3308
Mailing Address - Country:US
Mailing Address - Phone:310-531-6300
Mailing Address - Fax:
Practice Address - Street 1:5350 MACHADO ROAD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230
Practice Address - Country:US
Practice Address - Phone:310-204-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83587104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker