Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | LM 314 | CA |
NPI | 1063820835 |
---|---|
Provider Name | Mrs. Sandra Villafana |
First Address | Chula Vista, CA 91914-4160 |
Second Address | Chula Vista, CA 91914-4160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2014 |
Last Update Date | 24/07/2014 |