Provider Demographics
NPI:1154666212
Name:VILLALBA, GABRIELA GISELLE (MSN, FNP)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:GISELLE
Last Name:VILLALBA
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 ESTERS BLVD STE 900
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2233
Mailing Address - Country:US
Mailing Address - Phone:415-424-4266
Mailing Address - Fax:415-520-6633
Practice Address - Street 1:10775 PIONEER TRL STE 215
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-0234
Practice Address - Country:US
Practice Address - Phone:415-424-4266
Practice Address - Fax:415-520-6633
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015691363LF0000X
CA95019833363LF0000X
AZ267234363LF0000X
IL209024548363LF0000X
GAGAA-NP001297363LF0000X
VA0024188995363LF0000X
MDAC004962363LF0000X
TXAP122312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD884029600Medicaid
VA30017730700001Medicaid
TX1154666212Medicaid
FL117518900Medicaid
CA100252758Medicaid