Provider Demographics
NPI:1649169566
Name:KATZ-VILLALOBOS, JANE
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:KATZ-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 1:49095 BALADA CT
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2445
Mailing Address - Country:US
Mailing Address - Phone:760-898-2058
Mailing Address - Fax:
Practice Address - Street 1:44105 JACKSON ST STE 101
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-3280
Practice Address - Country:US
Practice Address - Phone:760-898-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty