Healthcare Provider Details

I. General information

NPI: 1932933231
Provider Name (Legal Business Name): GISELLE VILLALOBOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7285 QUILL DR
DOWNEY CA
90242-2098
US

IV. Provider business mailing address

1255 E 46TH ST
LOS ANGELES CA
90011-3728
US

V. Phone/Fax

Practice location:
  • Phone: 562-940-8681
  • Fax:
Mailing address:
  • Phone: 323-507-5949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: