Most Relevant Information
Provider Data
| NPI Number: | 1003497413 |
| Provider Name: | JACQUELINE MONIQUE VILLALVA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | BACB676340 |
Most Important Dates
| Enumeration Date: | 04/16/2021 |
| Last Updated: | 04/16/2021 |
Provider Practice Location
5075 SHOREHAM PL STE 115
SAN DIEGO
CA
921225927
Practice Location Phone/Fax
| Phone: | 8582722662 |
| Fax: | 8582722661 |
Provider Mailing Location
310 G ST APT 7
CHULA VISTA
CA
919104525
Provider Mailing Phone/Fax
| Phone: | 6194951091 |
| Fax: |