Provider Demographics
NPI:1225362452
Name:VILLALOBOS, LOUIE
Entity Type:Individual
Prefix:MR
First Name:LOUIE
Middle Name:
Last Name:VILLALOBOS
Suffix:
Gender:M
Credentials:
Other - Prefix:MS
Other - First Name:KARINA
Other - Middle Name:
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:611 E BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-1502
Mailing Address - Country:US
Mailing Address - Phone:559-237-3420
Mailing Address - Fax:559-485-7244
Practice Address - Street 1:611 E BELMONT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1502
Practice Address - Country:US
Practice Address - Phone:559-237-3420
Practice Address - Fax:559-485-7244
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)