Provider Demographics
NPI:1376985465
Name:MCKEARIN, GABRIELA MARIA (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:MARIA
Last Name:MCKEARIN
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:MARIA
Other - Last Name:CARCAMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:717 ROCKAWAY CT
Mailing Address - Street 2:APT #3
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-7117
Mailing Address - Country:US
Mailing Address - Phone:703-597-2586
Mailing Address - Fax:
Practice Address - Street 1:717 ROCKAWAY CT
Practice Address - Street 2:APT 3
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-7117
Practice Address - Country:US
Practice Address - Phone:703-597-2586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-13-13464103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst