Provider Demographics
NPI:1194844217
Name:SECHE, GAIL P (MMSC, RD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:P
Last Name:SECHE
Suffix:
Gender:F
Credentials:MMSC, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5941 KEITH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1545
Mailing Address - Country:US
Mailing Address - Phone:510-428-3885
Mailing Address - Fax:510-654-4753
Practice Address - Street 1:5941 KEITH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1545
Practice Address - Country:US
Practice Address - Phone:510-428-3885
Practice Address - Fax:510-654-4753
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric