Healthcare Provider Details

I. General information

NPI: 1033167853
Provider Name (Legal Business Name): JO GILBERT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 JEFFERSON ST STE. 600A
NAPA CA
94559-2442
US

IV. Provider business mailing address

1303 JEFFERSON ST STE. 600A
NAPA CA
94559-2442
US

V. Phone/Fax

Practice location:
  • Phone: 707-224-2893
  • Fax: 707-224-2894
Mailing address:
  • Phone: 707-224-2893
  • Fax: 707-224-2894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY7471
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY7471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: