| Doctor Name: | EDGAR ANTONIO VILLA |
| NPI Number: | 1053608570 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 28065 |
| Business Practice Address: | 341 S Hilllcrest Street La Habra Cerritos, CA - 907032640 |
| Business Phone Number: | 5626913263 |
| Business Fax Number: | |
| Mailing Address: | 341 Hillcrest St, LA HABRA |
| State: | CA |
| Postal Code: | 906315340 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2011 |
| NPI Last Update Date: | 02/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 28065 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |