Provider Demographics
NPI:1114042918
Name:JASSO TAPIA, GABRIELA (LCSW)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:JASSO TAPIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 W VENTURA ST STE 240
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1882
Mailing Address - Country:US
Mailing Address - Phone:805-524-8659
Mailing Address - Fax:
Practice Address - Street 1:828 W VENTURA ST STE 240
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1882
Practice Address - Country:US
Practice Address - Phone:805-524-8659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical