Provider Demographics
NPI:1689200446
Name:TRAINER, GABRIEL MARTIN (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:MARTIN
Last Name:TRAINER
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2009
Mailing Address - Country:US
Mailing Address - Phone:469-525-8251
Mailing Address - Fax:
Practice Address - Street 1:899 E CHARLESTON RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4644
Practice Address - Country:US
Practice Address - Phone:650-433-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23302235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist