1588901748 NPI number — LEOPOLDO F. VILLELA PSYCOLOGIST,INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588901748 NPI number — LEOPOLDO F. VILLELA PSYCOLOGIST,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEOPOLDO F. VILLELA PSYCOLOGIST,INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588901748
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2595 MISSION ST
Provider Second Line Business Mailing Address:
SUITE 211
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94110-2572
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-641-7169
Provider Business Mailing Address Fax Number:
415-641-0307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2595 MISSION ST
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94110-2572
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-641-7169
Provider Business Practice Location Address Fax Number:
415-641-0307
Provider Enumeration Date:
01/08/2013

Additional Information

Authorized Official

Authorized Official Last Name:
VILLELA
Authorized Official First Name:
LEOPOLDO
Authorized Official Middle Name:
FELIX
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
415-641-7169

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY11333 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com