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NPI Code Detail

MEDICARE: DR. JUANA GATSON PHD

MEDICARE: DR. JUANA GATSON PHD
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
1103T00000XPsychologist94026048CA

General Provider Information

NPI Number : 1295489136
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUANA GATSON PHD
Provider Business Mailing Address
First Line : 8939 S SEPULVEDA BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3667
Country : US
Telephone Number : 866-863-4645
Fax Number : 866-863-4824
Provider Business Practice Location Address
First Line : 8939 S SEPULVEDA BLVD STE 200
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3667
Country : US
Telephone Number : 866-863-4645
Fax Number : 866-863-4824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2022
Last Update Date : 02/09/2022

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Directions to “ DR. JUANA GATSON PHD” Practice Location

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