Healthcare Provider Details

I. General information

NPI: 1245906205
Provider Name (Legal Business Name): GABRIELA ANDREA MOLINA MARQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date: 08/21/2021
Reactivation Date: 08/11/2022

III. Provider practice location address

3419 VALLE VERDE DR
NAPA CA
94558-2414
US

IV. Provider business mailing address

3442 BOWTHORPE LN
APOPKA FL
32703-9015
US

V. Phone/Fax

Practice location:
  • Phone: 707-299-8250
  • Fax:
Mailing address:
  • Phone: 910-685-4365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0863
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: