Most Relevant Information
Provider Data
| NPI Number: | 1003520560 |
| Provider Name: | TIFFANY GISELLE VILLA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 00018024 |
Most Important Dates
| Enumeration Date: | 01/10/2023 |
| Last Updated: | 01/10/2023 |
Provider Practice Location
7525 METROPOLITAN DR STE 302
SAN DIEGO
CA
921084404
Practice Location Phone/Fax
| Phone: | 8582524858 |
| Fax: |
Provider Mailing Location
3046 1/2 CANON ST
SAN DIEGO
CA
921062672
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |