Provider Demographics
NPI:1275073975
Name:DEPILLIS, GRETCHEN (GRETEL) (CHRISTIAN COUNSEL)
Entity Type:Individual
Prefix:
First Name:GRETCHEN (GRETEL)
Middle Name:
Last Name:DEPILLIS
Suffix:
Gender:F
Credentials:CHRISTIAN COUNSEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18100 SHADY SIDE LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-9733
Mailing Address - Country:US
Mailing Address - Phone:312-622-6220
Mailing Address - Fax:
Practice Address - Street 1:18100 SHADY SIDE LN
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-9733
Practice Address - Country:US
Practice Address - Phone:951-789-0978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable