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General NPI Number Information
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NPI Number | 1306375928
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Entity Type | Organization
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Legal Business Name | THE GATEWAY INSTITUTE
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Dates
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Enumeration Date | 06/07/2017
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Last Update Date | 06/07/2017
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Provider Practice Location Address
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Address Line | 9375 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6991
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Country | US
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Telephone | 480-214-9543
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Fax |
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Provider Business Mailing Address
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Address Line | 950 S COAST DR STE 220
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City | COSTA MESA
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State | CA
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Zip | 92626-7813
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Country | US
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Telephone | 714-549-1030
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JAMES STERNER
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Credential | LMFT
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Telephone | 714-549-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 46088
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License Number State | CA
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