Provider Demographics
NPI:1063128759
Name:VILLASENOR CARRILLO, ANEL
Entity type:Individual
Prefix:MRS
First Name:ANEL
Middle Name:
Last Name:VILLASENOR CARRILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANEL
Other - Middle Name:
Other - Last Name:CARRILLO-ALCALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 W FIG ST
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2846
Mailing Address - Country:US
Mailing Address - Phone:442-207-9249
Mailing Address - Fax:
Practice Address - Street 1:123 E ALVARADO ST
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2049
Practice Address - Country:US
Practice Address - Phone:760-645-3447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty