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NPI Code Detail

MEDICARE: KAITLIN FAITH GALLARDO GINES

MEDICARE: KAITLIN FAITH GALLARDO GINES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language AssistantCA

General Provider Information

NPI Number : 1003527383
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLIN FAITH GALLARDO GINES
Provider Business Mailing Address
First Line : 6800 BROCKTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-3835
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6800 BROCKTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-3835
Country : US
Telephone Number : 951-776-1966
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2022
Last Update Date : 04/13/2026

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Directions to “ KAITLIN FAITH GALLARDO GINES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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