Provider Demographics
NPI:1235405903
Name:VILLALOBOS, MARIA (BA)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:
Last Name:VILLALOBOS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10221 COMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90002
Mailing Address - Country:US
Mailing Address - Phone:310-925-0825
Mailing Address - Fax:323-249-0776
Practice Address - Street 1:10221 COMPTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-2802
Practice Address - Country:US
Practice Address - Phone:310-925-0825
Practice Address - Fax:323-249-0776
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator