Provider Demographics
NPI:1467825521
Name:ZAYER, GISELLE (MSW)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:ZAYER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12405 ROYAL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8824
Mailing Address - Country:US
Mailing Address - Phone:909-260-3866
Mailing Address - Fax:951-242-7733
Practice Address - Street 1:12405 ROYAL OAKS DR
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-8824
Practice Address - Country:US
Practice Address - Phone:909-260-3866
Practice Address - Fax:951-242-7733
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW69270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health