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General NPI Number Information
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NPI Number | 1558206276
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Entity Type | Individual
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Provider Name | VICTOR ADAN VILLALOBOS
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Gender | Male
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 801 E 4TH ST STE 7
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City | GILLETTE
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State | WY
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Zip | 82716-4061
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Country | US
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Telephone | 408-201-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 708 VIVIAN ST APT 4
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City | GILLETTE
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State | WY
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Zip | 82718-6166
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Country | US
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Telephone | 307-299-6830
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | WY
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