Provider Demographics
NPI:1003077694
Name:GAUNA, AUTUMN NICOLE
Entity Type:Individual
Prefix:MISS
First Name:AUTUMN
Middle Name:NICOLE
Last Name:GAUNA
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 1:623 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1109
Mailing Address - Country:US
Mailing Address - Phone:626-304-9740
Mailing Address - Fax:
Practice Address - Street 1:5200 LANKERSHIM BLVD STE 170
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3184
Practice Address - Country:US
Practice Address - Phone:213-216-5473
Practice Address - Fax:213-216-5473
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner