Provider Demographics
NPI:1396207445
Name:VILLAROSA, REMEDIOS LINA CLAVEL (RN)
Entity type:Individual
Prefix:
First Name:REMEDIOS LINA
Middle Name:CLAVEL
Last Name:VILLAROSA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 SOUTH GARFIELD AVENUE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801
Mailing Address - Country:US
Mailing Address - Phone:626-280-8875
Mailing Address - Fax:626-573-8697
Practice Address - Street 1:1680 SOUTH GARFIELD AVENUE
Practice Address - Street 2:SUITE 205
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801
Practice Address - Country:US
Practice Address - Phone:626-280-8875
Practice Address - Fax:626-573-8697
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA717624171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator