Provider Demographics
NPI:1568205235
Name:VILLALOBOS, CESAR DAMIAN (MA)
Entity type:Individual
Prefix:MR
First Name:CESAR
Middle Name:DAMIAN
Last Name:VILLALOBOS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 CASEY DR
Mailing Address - Street 2:
Mailing Address - City:MINOOKA
Mailing Address - State:IL
Mailing Address - Zip Code:60447-9034
Mailing Address - Country:US
Mailing Address - Phone:520-904-5913
Mailing Address - Fax:
Practice Address - Street 1:113 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-2305
Practice Address - Country:US
Practice Address - Phone:630-733-9108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional