Provider Demographics
NPI:1225152549
Name:VILLAFLOR, GABE CHRISTIAN O (PT)
Entity Type:Individual
Prefix:
First Name:GABE CHRISTIAN
Middle Name:O
Last Name:VILLAFLOR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:GABE
Other - Middle Name:C
Other - Last Name:VILLAFLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1033 KIRKHILL DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-9524
Mailing Address - Country:US
Mailing Address - Phone:916-400-1005
Mailing Address - Fax:
Practice Address - Street 1:1680 E ROSEVILLE PKWY
Practice Address - Street 2:SUITE 112
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3988
Practice Address - Country:US
Practice Address - Phone:916-486-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32077225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist