Provider Demographics
NPI:1356753669
Name:VILLANUEVA, MARIA ELLA RICA (OTR/L)
Entity type:Individual
Prefix:
First Name:MARIA ELLA RICA
Middle Name:
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:RICA
Other - Middle Name:
Other - Last Name:VILLANUEVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:774 S PLACENTIA AVE
Mailing Address - Street 2:200
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870
Mailing Address - Country:US
Mailing Address - Phone:818-749-5488
Mailing Address - Fax:
Practice Address - Street 1:774 S PLACENTIA AVE
Practice Address - Street 2:200
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6826
Practice Address - Country:US
Practice Address - Phone:818-749-5488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics