Provider Demographics
NPI:1932664729
Name:CONTRERAS, GLADYS (VOLUNTEER)
Entity Type:Individual
Prefix:MS
First Name:GLADYS
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:VOLUNTEER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 MARENGO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1319
Mailing Address - Country:US
Mailing Address - Phone:323-987-1034
Mailing Address - Fax:323-987-1402
Practice Address - Street 1:2032 MARENGO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1319
Practice Address - Country:US
Practice Address - Phone:323-987-1034
Practice Address - Fax:323-987-1402
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit