Provider Demographics
NPI:1306356969
Name:GATAPIA, MARY GRACE ANTONETTE ABEAR (MFTI, PPCI)
Entity Type:Individual
Prefix:
First Name:MARY GRACE ANTONETTE
Middle Name:ABEAR
Last Name:GATAPIA
Suffix:
Gender:F
Credentials:MFTI, PPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 AUBURN BLVD. BLDG #3
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610
Mailing Address - Country:US
Mailing Address - Phone:916-722-6100
Mailing Address - Fax:916-722-9229
Practice Address - Street 1:8421 AUBURN BLVD STE 3
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-0391
Practice Address - Country:US
Practice Address - Phone:916-722-6100
Practice Address - Fax:916-722-9229
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2019-08-06
Deactivation Date:2017-10-11
Deactivation Code:
Reactivation Date:2017-10-18
Provider Licenses
StateLicense IDTaxonomies
CAIMF100848106H00000X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist