Provider Demographics
NPI:1245808310
Name:VILLAFLOR, NERIZA SANTOS (RDA)
Entity type:Individual
Prefix:
First Name:NERIZA
Middle Name:SANTOS
Last Name:VILLAFLOR
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14340 CHRISTINE DR APT 8
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1576
Mailing Address - Country:US
Mailing Address - Phone:562-556-7307
Mailing Address - Fax:
Practice Address - Street 1:14340 CHRISTINE DR APT 8
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1576
Practice Address - Country:US
Practice Address - Phone:562-556-7307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA86919Medicaid