Provider Demographics
NPI:1790525376
Name:VILLALVAZO, ISRAEL (RN)
Entity type:Individual
Prefix:
First Name:ISRAEL
Middle Name:
Last Name:VILLALVAZO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 STONE ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2672
Mailing Address - Country:US
Mailing Address - Phone:323-253-9756
Mailing Address - Fax:831-775-8092
Practice Address - Street 1:1441 SCHILLING PL
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4543
Practice Address - Country:US
Practice Address - Phone:831-809-9456
Practice Address - Fax:831-775-8092
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95186773163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care