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General NPI Number Information
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NPI Number | 1245110469
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Entity Type | Individual
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Provider Name | THOMAS JOSEPH GATES
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Gender | Male
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 12341 NEWPORT AVE STE A201
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City | SANTA ANA
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State | CA
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Zip | 92705-3289
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Country | US
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Telephone | 909-654-2968
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Fax |
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Provider Business Mailing Address
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Address Line | 35170 PRICE ST
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City | BEAUMONT
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State | CA
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Zip | 92223-6271
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 17820
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License Number State | CA
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