Gabriela D Anzo

Individual provider Active NPI Licensed Psychiatric Technician · La Verne, CA

NPI 1689950784 · NPPES record last updated Nov 2, 2011

Key facts

NPI
1689950784
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Psychiatric Technician 167G00000X
License
35540 (CA)
Practice address
233 Baseline Rd
La Verne, CA 91750-2353
Phone
(909) 593-2581
NPI assigned
Nov 2, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X 35540 CA Yes

Addresses

Primary practice location

233 Baseline Rd
La Verne, CA 91750-2353

Mailing address

PO Box 400
La Verne, CA 91750-0400
Phone (909) 593-2581

Other identifiers

IdentifierTypeStateIssuer
756AOtherCAOUTPATIENT MENTAL HEALTH

Other providers in La Verne, CA

All providers in La Verne, CA · Licensed Psychiatric Technician in California

Sources for this page

Verify at the official NPI Registry.