Healthcare Provider Details

I. General information

NPI: 1407983570
Provider Name (Legal Business Name): CYNTHIA E GABERT BSN, RNFA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 PAMELA LN
MODESTO CA
95350-2530
US

IV. Provider business mailing address

2417 PAMELA LN
MODESTO CA
95350-2530
US

V. Phone/Fax

Practice location:
  • Phone: 209-571-2075
  • Fax:
Mailing address:
  • Phone: 209-571-2075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. CYNTHIA EVELYN GABERT
Title or Position: RN, BSN, CNOR, RNFA
Credential: RN,BSN,RNFA
Phone: 209-571-2075