Provider Demographics
NPI:1063309540
Name:VILLA MEJIA, JAVIER N/A
Entity type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:N/A
Last Name:VILLA MEJIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MEDINA DR
Mailing Address - Street 2:
Mailing Address - City:PACHECO
Mailing Address - State:CA
Mailing Address - Zip Code:94553-6320
Mailing Address - Country:US
Mailing Address - Phone:925-639-8387
Mailing Address - Fax:
Practice Address - Street 1:175 MEDINA DR
Practice Address - Street 2:
Practice Address - City:PACHECO
Practice Address - State:CA
Practice Address - Zip Code:94553-6320
Practice Address - Country:US
Practice Address - Phone:925-639-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician