Provider Demographics
NPI:1912586975
Name:VELASCO, GABRIELA
Entity Type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:
Last Name:VELASCO
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 1:4650 W SUNSET BLVD # 53
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6062
Mailing Address - Country:US
Mailing Address - Phone:323-361-6678
Mailing Address - Fax:323-361-8305
Practice Address - Street 1:3250 WILSHIRE BLVD.
Practice Address - Street 2:SUITE 500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-1427
Practice Address - Country:US
Practice Address - Phone:323-361-3849
Practice Address - Fax:323-361-8305
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator