Healthcare Provider Details

I. General information

NPI: 1518593771
Provider Name (Legal Business Name): GABRIELA VILLALOBOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16501 VENTURA BLVD STE 400
ENCINO CA
91436-2067
US

IV. Provider business mailing address

16501 VENTURA BLVD STE 400
ENCINO CA
91436-2067
US

V. Phone/Fax

Practice location:
  • Phone: 818-356-8106
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA1-25-82455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: