Provider Demographics
NPI:1073256988
Name:WASHINGTON, GAIL ELIZABETH (NONE)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:ELIZABETH
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:ELIZABETH
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:626 W LANCASTER BLVD # 52
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3108
Mailing Address - Country:US
Mailing Address - Phone:661-258-3211
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:626 W LANCASTER BLVD # 52
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3108
Practice Address - Country:US
Practice Address - Phone:661-258-3211
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician