Provider Demographics
NPI:1457085607
Name:MCELLIGOTT, GABRIELA ALICE MARGARET (RN)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:ALICE MARGARET
Last Name:MCELLIGOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 SCENIC AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94805-2068
Mailing Address - Country:US
Mailing Address - Phone:510-676-6157
Mailing Address - Fax:
Practice Address - Street 1:2850 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2703
Practice Address - Country:US
Practice Address - Phone:510-981-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95261091163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse