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General NPI Number Information
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NPI Number | 1255416145
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Entity Type | Individual
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Provider Name | MIRANDA J. GABRIEL PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 CHANNING AVE
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City | PALO ALTO
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State | CA
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Zip | 94301-2720
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Country | US
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Telephone | 650-688-3028
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Fax | 650-688-3029
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Provider Business Mailing Address
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Address Line | PO BOX 20357
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City | PIEDMONT
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State | CA
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Zip | 94620-0357
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Country | US
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Telephone | 510-459-1302
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 19388
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License Number State | CA
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