Provider Demographics
NPI:1013243724
Name:GAYMON, MICHELLE (PDC(DONA), AAHCC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:GAYMON
Suffix:
Gender:F
Credentials:PDC(DONA), AAHCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 42ND ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3113
Mailing Address - Country:US
Mailing Address - Phone:916-320-7172
Mailing Address - Fax:
Practice Address - Street 1:635 42ND ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3113
Practice Address - Country:US
Practice Address - Phone:916-320-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator