Provider Demographics
NPI:1184899361
Name:VILLALOBOS, KARISA MICHELE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KARISA
Middle Name:MICHELE
Last Name:VILLALOBOS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 I ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5110
Mailing Address - Country:US
Mailing Address - Phone:619-407-4057
Mailing Address - Fax:619-407-4089
Practice Address - Street 1:621 I ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5110
Practice Address - Country:US
Practice Address - Phone:619-407-4057
Practice Address - Fax:619-407-4089
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57815183500000X
OH03-2-26333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist