Provider Demographics
NPI:1184056012
Name:LARRIEUX VILLANUEVA, VICTORIA S (PHD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:S
Last Name:LARRIEUX VILLANUEVA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:S
Other - Last Name:LARRIEUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:631 CALLE ASTURIAS
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-2576
Mailing Address - Country:US
Mailing Address - Phone:787-688-0862
Mailing Address - Fax:
Practice Address - Street 1:66 CALLE MATTEI LLUBERAS
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3632
Practice Address - Country:US
Practice Address - Phone:787-688-0862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6226103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical