Provider Demographics
NPI:1023738655
Name:MORIE, GABRIELA JESSICA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:JESSICA
Last Name:MORIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:JESSICA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2629 W VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1814
Mailing Address - Country:US
Mailing Address - Phone:626-656-3898
Mailing Address - Fax:
Practice Address - Street 1:1520 N RAYMOND AVE BLDG 2-7
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1819
Practice Address - Country:US
Practice Address - Phone:626-396-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program