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NPI Code Detail

MEDICARE: DR. GABRIELLA CALO SIEGEL PSY.D.

MEDICARE:  DR. GABRIELLA CALO SIEGEL  PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1102L00000XPsychoanalystPSY 24517CA
2103T00000XPsychologistPSY 24517CA
3103TC0700XClinical PsychologistPSY 24517CA

General Provider Information

NPI Number : 1225315906
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GABRIELLA CALO SIEGEL PSY.D.
Provider Business Mailing Address
First Line : 547 WINCHESTER DR
Second Line :
City : OXNARD
State : CA
Zip : 93036-1464
Country : US
Telephone Number : 424-234-6169
Fax Number : 310-870-3812
Provider Business Practice Location Address
First Line : 8549 WILSHIRE BLVD UNIT 3142
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-3104
Country : US
Telephone Number : 424-234-6169
Fax Number : 310-870-3812
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2011
Last Update Date : 05/23/2024

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