Healthcare Provider Details

I. General information

NPI: 1437463403
Provider Name (Legal Business Name): GAIL TONI TESTA M.S., M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S GRAND AVE
SANTA ANA CA
92705-4121
US

IV. Provider business mailing address

4426 GRAYWOOD AVE
LONG BEACH CA
90808-1320
US

V. Phone/Fax

Practice location:
  • Phone: 714-687-6740
  • Fax:
Mailing address:
  • Phone: 562-377-1151
  • Fax: 562-377-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberNA
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: