Provider Demographics
NPI:1154121358
Name:VILLANUEVA, ANGELA GRACE LLAMAS (FNP-C)
Entity type:Individual
Prefix:
First Name:ANGELA GRACE
Middle Name:LLAMAS
Last Name:VILLANUEVA
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 E OLYMPIC DR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-7278
Mailing Address - Country:US
Mailing Address - Phone:714-603-9616
Mailing Address - Fax:
Practice Address - Street 1:3232 E OLYMPIC DR
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-7278
Practice Address - Country:US
Practice Address - Phone:714-603-9616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033468363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily