Provider Demographics
NPI:1144598673
Name:GUNNER, MARIBEL
Entity Type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:
Last Name:GUNNER
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 1:31929 EUREKA CIR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8728
Mailing Address - Country:US
Mailing Address - Phone:909-565-6812
Mailing Address - Fax:
Practice Address - Street 1:31929 EUREKA CIR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-8728
Practice Address - Country:US
Practice Address - Phone:909-565-6812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator