Healthcare Provider Details

I. General information

NPI: 1639528961
Provider Name (Legal Business Name): FRANK JAY GATES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11418 RAGAN WAY
GRASS VALLEY CA
95949-6723
US

IV. Provider business mailing address

11418 RAGAN WAY
GRASS VALLEY CA
95949-6723
US

V. Phone/Fax

Practice location:
  • Phone: 916-250-9315
  • Fax:
Mailing address:
  • Phone: 530-250-9315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: