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NPI Code Detail

MEDICARE: MS. GAYLE PEITSO LCSW

MEDICARE:  MS. GAYLE  PEITSO  LCSW
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
11041C0700XClinical Social Worker70049CA

General Provider Information

NPI Number : 1578010526
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GAYLE PEITSO LCSW
Provider Business Mailing Address
First Line : 15780 HIGHLAND DR
Second Line :
City : SAN JOSE
State : CA
Zip : 95127-1741
Country : US
Telephone Number : 408-568-1011
Fax Number :
Provider Business Practice Location Address
First Line : 15780 HIGHLAND DR
Second Line :
City : SAN JOSE
State : CA
Zip : 95127-1741
Country : US
Telephone Number : 408-568-1011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2016
Last Update Date : 09/07/2016

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Directions to “ MS. GAYLE PEITSO LCSW” Practice Location

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