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NPI Code Detail

MEDICARE: MS. GICELE Q CORPUZ

MEDICARE: MS. GICELE Q CORPUZ
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
1103K00000XBehavior Analyst1-20-42276

General Provider Information

NPI Number : 1740787779
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GICELE Q CORPUZ
Provider Business Mailing Address
First Line : PO BOX 360464
Second Line :
City : MILPITAS
State : CA
Zip : 95036-0464
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6325 S JONES BLVD STE 400
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-3332
Country : US
Telephone Number : 702-766-9840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2018
Last Update Date : 02/12/2025

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