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NPI Code Detail

MEDICARE: MRS. OFELIA O GALLEGOS II

MEDICARE: MRS. OFELIA O GALLEGOS II
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
1101YA0400XAddiction (Substance Use Disorder) CounselorG0412282026CA
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1104083062
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OFELIA O GALLEGOS II
Provider Business Mailing Address
First Line : 200 7TH AVE STE 150
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062-4669
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 7TH AVE STE 150
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95062-4669
Country : US
Telephone Number : 831-462-1060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2008
Last Update Date : 01/05/2023

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Directions to “ MRS. OFELIA O GALLEGOS II ” Practice Location

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