Provider Demographics
NPI:1285471508
Name:VILLALOBOS, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:VILLALOBOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14707 E 2ND AVE # GL100
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8965
Mailing Address - Country:US
Mailing Address - Phone:720-206-9644
Mailing Address - Fax:
Practice Address - Street 1:14707 E 2ND AVE # GL100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8965
Practice Address - Country:US
Practice Address - Phone:720-206-9644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0-24-15337106E00000X
TX1-24-78484103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst