Provider Demographics
NPI:1700129632
Name:KANE, GAIL MALIA
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:MALIA
Last Name:KANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 SARTORI AVE
Mailing Address - Street 2:APT. F
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-0306
Mailing Address - Country:US
Mailing Address - Phone:310-619-5814
Mailing Address - Fax:
Practice Address - Street 1:703 SARTORI AVE
Practice Address - Street 2:APT F
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501
Practice Address - Country:US
Practice Address - Phone:310-619-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)