Provider Demographics
NPI:1932966892
Name:VILLACARTE, ANNETTE DOREEN (NP)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:DOREEN
Last Name:VILLACARTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:DOREEN
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2810 RUTHERFORD CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-7341
Mailing Address - Country:US
Mailing Address - Phone:925-922-3805
Mailing Address - Fax:
Practice Address - Street 1:1661 MT DIABLO BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4517
Practice Address - Country:US
Practice Address - Phone:925-266-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily