Provider Demographics
NPI:1023888005
Name:HOJILLA, LOVELYN GINOO
Entity type:Individual
Prefix:
First Name:LOVELYN
Middle Name:GINOO
Last Name:HOJILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 RIDGECREST CIR
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-1787
Mailing Address - Country:US
Mailing Address - Phone:707-515-8057
Mailing Address - Fax:707-240-0091
Practice Address - Street 1:224 LOCH LOMOND DR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-5194
Practice Address - Country:US
Practice Address - Phone:707-515-8057
Practice Address - Fax:707-240-0091
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities