Healthcare Provider Details
I. General information
NPI: 1508249343
Provider Name (Legal Business Name): GAIL JANINE FIERRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/29/2015
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 HARBOR BLVD
BELMONT CA
94002-4018
US
IV. Provider business mailing address
300 HARBOR BLVD
BELMONT CA
94002-4018
US
V. Phone/Fax
- Phone: 650-817-9070
- Fax: 650-246-3838
- Phone: 650-817-9070
- Fax: 650-246-3838
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: