Provider Demographics
NPI:1609027077
Name:TERAN, GABRIEL GREGORY (CATCI)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:GREGORY
Last Name:TERAN
Suffix:
Gender:M
Credentials:CATCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ROSEWOOD AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5914
Mailing Address - Country:US
Mailing Address - Phone:805-482-1265
Mailing Address - Fax:805-389-5295
Practice Address - Street 1:450 ROSEWOOD AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-5914
Practice Address - Country:US
Practice Address - Phone:805-482-1265
Practice Address - Fax:805-389-5295
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1761I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)