Provider Demographics
NPI:1760738389
Name:PASCOE, GAIL MILDRED (RN, MFT)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:MILDRED
Last Name:PASCOE
Suffix:
Gender:F
Credentials:RN, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 HARRIS STREET
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503
Mailing Address - Country:US
Mailing Address - Phone:707-362-6951
Mailing Address - Fax:707-445-4666
Practice Address - Street 1:618 HARRIS STREET
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503
Practice Address - Country:US
Practice Address - Phone:707-362-6951
Practice Address - Fax:707-445-4666
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25083106H00000X
CARN208554163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health