Provider Demographics
NPI:1558671297
Name:GAISER, ANGELA MAY
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MAY
Last Name:GAISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOAH
Other - Middle Name:
Other - Last Name:GAISER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1039 57TH STREET
Mailing Address - Street 2:APT. B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608
Mailing Address - Country:US
Mailing Address - Phone:707-477-6547
Mailing Address - Fax:
Practice Address - Street 1:2500 BISSELL AVENUE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804
Practice Address - Country:US
Practice Address - Phone:510-231-3946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator