Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 20A12479 | CA |
NPI | 1144511262 |
---|---|
Provider Name | Farah Jehan Villanueva |
First Address | Torrance, CA 90503-5970 |
Second Address | Torrance, CA 90503-4607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2011 |
Last Update Date | 18/11/2021 |