Provider Demographics
NPI:1730559055
Name:VILLANEUVA, DIANA (BSW)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:VILLANEUVA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:PATRICIA
Other - Last Name:NIETO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1101 LOPEZ ROAD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105
Mailing Address - Country:US
Mailing Address - Phone:505-877-7060
Mailing Address - Fax:505-877-7063
Practice Address - Street 1:209 SAN PABLO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108
Practice Address - Country:US
Practice Address - Phone:505-944-7224
Practice Address - Fax:505-944-7229
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker