Healthcare Provider Details

I. General information

NPI: 1851540074
Provider Name (Legal Business Name): YULIANA GELB M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

IV. Provider business mailing address

3626 BALBOA ST
SAN FRANCISCO CA
94121-2604
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-5960
  • Fax:
Mailing address:
  • Phone: 415-668-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: