Healthcare Provider Details

I. General information

NPI: 1861945792
Provider Name (Legal Business Name): DR. LARYSSA PATRICIA VILLALOBOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. LARYSSA PATRICIA VILLALOBOS-MORLET

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S HILL ST
LOS ANGELES CA
90012-3506
US

IV. Provider business mailing address

222 S HILL ST
LOS ANGELES CA
90012-3506
US

V. Phone/Fax

Practice location:
  • Phone: 626-403-4390
  • Fax:
Mailing address:
  • Phone: 626-403-4390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: