Provider Demographics
NPI:1013156819
Name:VILLANUEVA GARCIA, LILLIANA (PSYD)
Entity Type:Individual
Prefix:
First Name:LILLIANA
Middle Name:
Last Name:VILLANUEVA GARCIA
Suffix:
Gender:F
Credentials:PSYD
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 43002
Mailing Address - Street 2:SUITE 515
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-3002
Mailing Address - Country:US
Mailing Address - Phone:787-221-3421
Mailing Address - Fax:305-675-7910
Practice Address - Street 1:CARR 876 KM 3.2
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-221-3421
Practice Address - Fax:305-675-7910
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3177103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical