=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407201726
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GABRIELA AMAYA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2016
-----------------------------------------------------
Last Update Date | 05/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1950 MARKET ST
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92501-1720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-247-6064
-----------------------------------------------------
Fax | 951-242-6201
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3877 12TH ST
-----------------------------------------------------
City | RIVERSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92501-3578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-247-6064
-----------------------------------------------------
Fax | 951-242-6201
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 373H00000X
-----------------------------------------------------
Taxonomy Name | Day Training/Habilitation Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------