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NPI Code Detail

MEDICARE: KIANA GIPSON

MEDICARE: KIANA GIPSON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1952586794
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIANA GIPSON
Provider Business Mailing Address
First Line : 7650 AMHERST ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95832-1024
Country : US
Telephone Number : 916-665-1804
Fax Number :
Provider Business Practice Location Address
First Line : 7650 AMHERST ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95832-1024
Country : US
Telephone Number : 916-665-1804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2007
Last Update Date : 12/28/2007

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Directions to “ KIANA GIPSON ” Practice Location

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