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NPI Code Detail

MEDICARE: MR. CHRIS SOCORRO VILLALOBOS CADC II

MEDICARE:  MR. CHRIS SOCORRO VILLALOBOS  CADC II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285854398
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRIS SOCORRO VILLALOBOS CADC II
Provider Business Mailing Address
First Line : 2501 W EL SEGUNDO BLVD
Second Line :
City : HAWTHORNE
State : CA
Zip : 90250-3317
Country : US
Telephone Number : 323-754-2816
Fax Number : 323-754-2828
Provider Business Practice Location Address
First Line : 2501 W EL SEGUNDO BLVD
Second Line :
City : HAWTHORNE
State : CA
Zip : 90250-3317
Country : US
Telephone Number : 323-754-2816
Fax Number : 323-754-2828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2007
Last Update Date : 11/03/2015

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Directions to “ MR. CHRIS SOCORRO VILLALOBOS CADC II” Practice Location

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