Provider Demographics
NPI:1740672757
Name:VILLAFLOR, ELNA C (ADMINISTRATOR)
Entity type:Individual
Prefix:MRS
First Name:ELNA
Middle Name:C
Last Name:VILLAFLOR
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1142 S DIAMOND BAR BLVD # 336
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2203
Mailing Address - Country:US
Mailing Address - Phone:909-860-2538
Mailing Address - Fax:909-860-5628
Practice Address - Street 1:1809 LEANING PINE DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-2740
Practice Address - Country:US
Practice Address - Phone:909-860-2538
Practice Address - Fax:909-860-5628
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA197801279310400000X
CA197801933310400000X
CA336407270310400000X
CA197606472310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility