Provider Demographics
NPI:1649066416
Name:VILLEGAS, FABIAN
Entity type:Individual
Prefix:
First Name:FABIAN
Middle Name:
Last Name:VILLEGAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9990 W 59TH PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-5098
Mailing Address - Country:US
Mailing Address - Phone:983-888-9975
Mailing Address - Fax:
Practice Address - Street 1:9990 W 59TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-5098
Practice Address - Country:US
Practice Address - Phone:983-888-9975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician