Most Relevant Information
Provider Data
| NPI Number: | 1003685371 |
| Provider Name: | ETHAN VILLANUEVA |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/27/2023 |
| Last Updated: | 07/02/2024 |
Provider Practice Location
368 FELL ST
SAN FRANCISCO
CA
941025144
Practice Location Phone/Fax
| Phone: | 4158610828 |
| Fax: |
Provider Mailing Location
368 FELL ST
SAN FRANCISCO
CA
941025144
Provider Mailing Phone/Fax
| Phone: | 4158610828 |
| Fax: |