Provider Demographics
NPI:1649938184
Name:MACIEL, GISELLE MARIA (NA)
Entity type:Individual
Prefix:
First Name:GISELLE
Middle Name:MARIA
Last Name:MACIEL
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16651 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-0952
Mailing Address - Country:US
Mailing Address - Phone:559-831-2127
Mailing Address - Fax:
Practice Address - Street 1:16651 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-0952
Practice Address - Country:US
Practice Address - Phone:559-706-7339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide