MEDICARE: GABRIELA BOTELLO

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
1	103K00000X	Behavior Analyst	1-23-65576	CA

General Provider Information

NPI Number	:	1477159184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA BOTELLO

Provider Business Mailing Address
First Line	:	6051 N FRESNO ST STE 102
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5280
Country	:	US
Telephone Number	:	559-650-7224
Fax Number	:

Provider Business Practice Location Address
First Line	:	6051 N FRESNO ST STE 102
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5280
Country	:	US
Telephone Number	:	559-650-7224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2020
Last Update Date	:	05/11/2026

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Directions to “ GABRIELA BOTELLO ” Practice Location

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