Gavrielle Concepcion Balibay, PHARMD
Individual provider Active NPI Pharmacist · Highland, CA
NPI 1336652429 · NPPES record last updated Jul 9, 2022
Key facts
- NPI
- 1336652429
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 77159 (CA)
- Practice address
- 27951 Baseline St
Highland, CA 92346-3346 - Phone
- (909) 864-5701
- NPI assigned
- Nov 10, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77159 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 77159 | CA | Yes |
Addresses
Primary practice location
27951 Baseline St
Highland, CA 92346-3346
Mailing address
1820 Plan Tree Dr
Upland, CA 91784-2523
Phone (909) 653-8418
Other providers in Highland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.