Provider Demographics
NPI:1932549144
Name:GONZALEZ VAZQUEZ, GABRIELA
Entity Type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:
Last Name:GONZALEZ VAZQUEZ
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 1:609 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92582-3290
Mailing Address - Country:US
Mailing Address - Phone:951-285-6105
Mailing Address - Fax:
Practice Address - Street 1:609 MEADOW VIEW DR
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-3290
Practice Address - Country:US
Practice Address - Phone:951-285-6105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst