Provider Demographics
NPI:1053701839
Name:VILLANUEVA, DEBORAH (LCSW)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3090 HACKETT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-4032
Mailing Address - Country:US
Mailing Address - Phone:310-266-2560
Mailing Address - Fax:
Practice Address - Street 1:3090 HACKETT AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-4032
Practice Address - Country:US
Practice Address - Phone:310-266-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CA823541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical