Provider Demographics
NPI:1386397644
Name:VILLALOBOS, CARI
Entity type:Individual
Prefix:MS
First Name:CARI
Middle Name:
Last Name:VILLALOBOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W COMMUNITY COLLEGE DRIVE #271
Mailing Address - Street 2:1125 FRONTIER AVE
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583
Mailing Address - Country:US
Mailing Address - Phone:951-567-0481
Mailing Address - Fax:
Practice Address - Street 1:800 W COMMUNITY COLLEGE DRIVE #271
Practice Address - Street 2:1125 FRONTIER AVE
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583
Practice Address - Country:US
Practice Address - Phone:951-567-0481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88373225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist