Provider Demographics
NPI:1740827872
Name:VILLANUEVA, CHRISTINA LIEZL (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINA LIEZL
Middle Name:
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26357 MCBEAN PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4497
Mailing Address - Country:US
Mailing Address - Phone:661-593-7379
Mailing Address - Fax:661-568-6856
Practice Address - Street 1:26357 MCBEAN PKWY STE 210
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-4497
Practice Address - Country:US
Practice Address - Phone:661-593-7379
Practice Address - Fax:661-568-6856
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012190363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care