Healthcare Provider Details

I. General information

NPI: 1104944941
Provider Name (Legal Business Name): SHEILA MARIE GASTON-CRUZ M.S., P.P.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEILA MARIE LEMUS M.S., P.P.S.

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 N RAYMOND AVE SUITE 200
ANAHEIM CA
92801-1120
US

IV. Provider business mailing address

1661 N RAYMOND AVE SUITE 200
ANAHEIM CA
92801-1120
US

V. Phone/Fax

Practice location:
  • Phone: 714-966-8683
  • Fax:
Mailing address:
  • Phone: 714-966-8683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: