Individual
JAIRO OSMIN VILLALOBOS TEJADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 CHILDRENS CIR, SANTA ROSA, CA 95409-6558
(707) 565-6350
(707) 565-6350
Mailing address
112 CHILDRENS CIR, SANTA ROSA, CA 95409-6558
(707) 565-6350
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
CA
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
03/02/2022
Last updated
08/09/2025
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