Provider Demographics
NPI:1346802378
Name:SERRANO JUAREZ, GABRIELA C
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:C
Last Name:SERRANO JUAREZ
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 1:198 NAPLES ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2011
Mailing Address - Country:US
Mailing Address - Phone:415-902-6918
Mailing Address - Fax:
Practice Address - Street 1:198 NAPLES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2011
Practice Address - Country:US
Practice Address - Phone:415-902-6918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA13392281OtherKAISER PERMANENTE