| Doctor Name: | MR. RAYMOND A VILLAVERDE |
| NPI Number: | 1033118237 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | 085-001011 |
| Business Practice Address: | 4140 Jade St Suite 100 Capitola, CA - 950103956 |
| Business Phone Number: | 8314754344 |
| Business Fax Number: | 8314754344 |
| Mailing Address: | 4140 Jade St, Suite 100 CAPITOLA |
| State: | CA |
| Postal Code: | 950103956 |
| Phone Number: | 8314754344 |
| Fax Number: | 8314754344 |
| NPI Enumeration Date: | 07/19/2005 |
| NPI Last Update Date: | 08/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SM0705X |
| License Number: | 085-001011 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |