| Doctor Name: | MR. MARK VILLARREAL |
| NPI Number: | 1053625475 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 26031 |
| Business Practice Address: | 8841 Williamson Dr Ste 20 Elk Grove, CA - 956241800 |
| Business Phone Number: | 4086558358 |
| Business Fax Number: | 9166865552 |
| Mailing Address: | 7218 Serta Ct, ELK GROVE |
| State: | CA |
| Postal Code: | 957573461 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/27/2010 |
| NPI Last Update Date: | 07/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 26031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |