Healthcare Provider Details

I. General information

NPI: 1437061728
Provider Name (Legal Business Name): MARIA A GURROLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 ALTA ST.
GONZALEZ CA
93926
US

IV. Provider business mailing address

PO BOX 1641
GREENFIELD CA
93927-1641
US

V. Phone/Fax

Practice location:
  • Phone: 401-542-8427
  • Fax:
Mailing address:
  • Phone: 401-542-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW139408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: