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General NPI Number Information
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NPI Number | 1447491964
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Entity Type | Individual
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Provider Name | GABRIELA E. SWEIDAN
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Gender | Female
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 09/11/2009
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Provider Practice Location Address
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Address Line | 4570 CAMPUS DR. SUITE # 8
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-375-7276
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Fax | 949-706-0792
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Provider Business Mailing Address
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Address Line | 4570 CAMPUS DR SUITE #8
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-8809
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Country | US
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Telephone | 949-375-7276
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Fax | 949-706-0792
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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 | PSY20654
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License Number State | CA
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