Provider Demographics
NPI:1528639028
Name:UVILLUS LEGARDA, OSCAR LUIS
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:LUIS
Last Name:UVILLUS LEGARDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 N HERMOSA DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6100
Mailing Address - Country:US
Mailing Address - Phone:713-923-0175
Mailing Address - Fax:
Practice Address - Street 1:6117 BROCKTON AVE STE NO202
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2232
Practice Address - Country:US
Practice Address - Phone:951-440-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst