Provider Demographics
NPI:1184729295
Name:ACEVEDO, GISELA (RN, BSN, PHN)
Entity type:Individual
Prefix:MS
First Name:GISELA
Middle Name:
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:RN, BSN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4065 COUNTY CIRCLE DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3410
Mailing Address - Country:US
Mailing Address - Phone:951-358-5438
Mailing Address - Fax:951-358-4762
Practice Address - Street 1:47923 OASIS ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-9203
Practice Address - Country:US
Practice Address - Phone:760-863-8383
Practice Address - Fax:760-863-8186
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61552163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management