Provider Demographics
NPI:1457182750
Name:VILLEGAS, JAVIER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:VILLEGAS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 N J ST
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-1917
Mailing Address - Country:US
Mailing Address - Phone:559-305-4770
Mailing Address - Fax:
Practice Address - Street 1:2440 W SHAW AVE STE 203
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3300
Practice Address - Country:US
Practice Address - Phone:559-878-3189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist