Provider Demographics
NPI:1508378878
Name:TOPLISS, GWENDOLYN S
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:S
Last Name:TOPLISS
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 1:5380 49TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-5328
Mailing Address - Country:US
Mailing Address - Phone:916-544-0543
Mailing Address - Fax:
Practice Address - Street 1:5380 49TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-5328
Practice Address - Country:US
Practice Address - Phone:916-544-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician