Provider Demographics
NPI:1003440470
Name:GABRIEL, MARIANNA HELEN (RD CHES)
Entity Type:Individual
Prefix:MS
First Name:MARIANNA
Middle Name:HELEN
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:RD CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PALACIO
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3440
Mailing Address - Country:US
Mailing Address - Phone:949-439-1544
Mailing Address - Fax:
Practice Address - Street 1:6640 ALTON PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3734
Practice Address - Country:US
Practice Address - Phone:949-932-6734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146M00000X
11815133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate