Individual provider Active NPI

Gabriela Bolivar Villalobos, PH.D.

  • Clinical Psychologist
  • Riverside, CA
National Provider Identifier
1427712801
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY33017 Issued in CA
Practice address
10329 Hole Ave
Riverside, CA 92505-1747
Phone
(951) 251-4034
NPI assigned
Oct 22, 2021
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY33017 CA Primary

Addresses

Primary practice location

10329 Hole Ave
Riverside, CA 92505-1747

Mailing address

10329 Hole Ave
Riverside, CA 92505-1747
Phone (951) 251-4034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220119002893 CA Practitioner - Clinical Psychologist 5890187041 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY33017CAMDClinical Psychologist
33017CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Feb 21, 2022 Accepting new patients
Reedley Community Hospital CurrentSince May 18, 2022 Accepting new patients
Reedley Community Hospital CurrentSince May 18, 2022 Accepting new patients
Adventist Health Physicians Network CurrentSince Feb 21, 2022 Accepting new patients
Sud Specialty Group - Ca CurrentSince Jul 1, 2025 Accepting new patients

Locations

1025 N Douty St
Hanford, CA 93230
Phone (559) 537-0170

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

372 W Cypress Ave
Reedley, CA 93654
Phone (559) 391-3110

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (323) 745-8323

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1427712801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10329 HOLE AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925051747",
            "telephone_number": "951-251-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10329 HOLE AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925051747",
            "telephone_number": "951-251-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR VILLALOBOS",
        "first_name": "GABRIELA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.