Provider Information for 1659964583
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Mrs. KISHA VILLA LCSW
Sex: Female
NPI: 1659964583
Last Updated: 2024-06-27
Certification Date: 2024-06-27
Certification Date: 2024-06-27
Details
| Name | Value | ||||||||
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| NPI | 1659964583 | ||||||||
| Enumeration Date | 2021-02-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 520 E TULARE AVE VISALIA, CA 93292-3629 United States Phone: 559-623-0900 | Fax: | ||||||||
| Primary Practice Address | 520 E TULARE AVE VISALIA, CA 93292-3629 United States Phone: 559-623-0900 | Fax: | ||||||||
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