Healthcare Provider Details

I. General information

NPI: 1376311001
Provider Name (Legal Business Name): CHRISTINA MARIE GBILIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 EMPIRE ST STE 120
FAIRFIELD CA
94533-5550
US

IV. Provider business mailing address

744 EMPIRE ST STE 120
FAIRFIELD CA
94533-5550
US

V. Phone/Fax

Practice location:
  • Phone: 415-474-7310
  • Fax: 707-901-4417
Mailing address:
  • Phone: 415-474-7310
  • Fax: 707-901-4417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number727801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: