Villanueva, Michael R

Villanueva, Michael R is an individual health care provider with primary practice located at 837 Alder Creek Dr , Medford OR 97504-8911. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is his primary health care specialty. Villanueva, Michael R can be contacted via phone (541) 608-3878.

Contact Information

Primary practice address
837 Alder Creek Dr Medford OR 97504-8911
Phone: (541) 608-3878
Fax: (541) 608-3880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 0974 Oregon
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0974 Oregon

Profile Details

NPI number 1063522860
LBN Legal business name Villanueva, Michael R
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jun 22nd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063522860 NPPES
Oregon MEDICAID 042601

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