Provider Demographics
NPI:1093585796
Name:MECATL, GISSEL
Entity Type:Individual
Prefix:
First Name:GISSEL
Middle Name:
Last Name:MECATL
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 1:1119 W SACRAMENTO AVE APT F
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-4388
Mailing Address - Country:US
Mailing Address - Phone:213-822-2919
Mailing Address - Fax:
Practice Address - Street 1:2167B MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4945
Practice Address - Country:US
Practice Address - Phone:530-538-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator