Healthcare Provider Details

I. General information

NPI: 1881968386
Provider Name (Legal Business Name): GABRIELA FLORES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2012
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1885 LUNDY AVE STE. 223
SAN JOSE CA
95131-1887
US

IV. Provider business mailing address

4146 HORIZON CT
SAN JOSE CA
95148-4354
US

V. Phone/Fax

Practice location:
  • Phone: 408-284-9048
  • Fax:
Mailing address:
  • Phone: 408-210-4543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: