Healthcare Provider Details

I. General information

NPI: 1740101377
Provider Name (Legal Business Name): GABRIELA CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14724 VENTURA BLVD SUITE 1105
SHERMAN OAKS CA
91403
US

IV. Provider business mailing address

14724 VENTURA BLVD SUITE 1105
SHERMAN OAKS CA
91403
US

V. Phone/Fax

Practice location:
  • Phone: 747-298-3480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: