Provider Demographics
NPI:1871891341
Name:VILLALOBOS, LUCILLE GOULART (MASTERS HEALTH ADMIN)
Entity type:Individual
Prefix:MRS
First Name:LUCILLE
Middle Name:GOULART
Last Name:VILLALOBOS
Suffix:
Gender:F
Credentials:MASTERS HEALTH ADMIN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:670 PLACERVILLE DR STE 1B
Mailing Address - Street 2:2813 DEBBIE LANE (OPTIONAL)
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-4200
Mailing Address - Country:US
Mailing Address - Phone:530-621-6244
Mailing Address - Fax:530-295-2565
Practice Address - Street 1:670 PLACERVILLE DR STE 1B
Practice Address - Street 2:2813 DEBBIE LANE (OPTIONAL)
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4200
Practice Address - Country:US
Practice Address - Phone:530-621-6244
Practice Address - Fax:530-295-2565
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker