Provider Demographics
NPI:1508331356
Name:KATANA, GABRIELLA MISHAY
Entity Type:Individual
Prefix:MISS
First Name:GABRIELLA
Middle Name:MISHAY
Last Name:KATANA
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 1:1825 W RAY RD APT 2135
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4095
Mailing Address - Country:US
Mailing Address - Phone:208-571-0585
Mailing Address - Fax:
Practice Address - Street 1:1825 W RAY RD APT 2135
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4095
Practice Address - Country:US
Practice Address - Phone:208-571-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program