Provider Demographics
NPI:1689408387
Name:VILLA-CABRERA, MARIA FERNANDA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:FERNANDA
Last Name:VILLA-CABRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4407
Mailing Address - Country:US
Mailing Address - Phone:775-786-4673
Mailing Address - Fax:
Practice Address - Street 1:1905 E 4TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3789
Practice Address - Country:US
Practice Address - Phone:775-786-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCHW1-5819172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker