Provider Demographics
NPI:1225503451
Name:KISSELL, ANA GABRIELA (BACHELOR OF ARTS)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:GABRIELA
Last Name:KISSELL
Suffix:
Gender:F
Credentials:BACHELOR OF ARTS
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:GABRIELA
Other - Last Name:CISNEROS-GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:702 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-3121
Mailing Address - Country:US
Mailing Address - Phone:541-889-9167
Mailing Address - Fax:541-889-7873
Practice Address - Street 1:595 NW 11TH ST
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-6600
Practice Address - Country:US
Practice Address - Phone:541-567-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health