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NPI Code Detail

MEDICARE: STEPHANIE ANN GAMBLIN

MEDICARE: STEPHANIE ANN GAMBLIN
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
1106H00000XMarriage & Family Therapist137458CA

General Provider Information

NPI Number : 1487128914
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ANN GAMBLIN
Provider Business Mailing Address
First Line : 238 S FLOWER ST
Second Line :
City : ORANGE
State : CA
Zip : 92868-3415
Country : US
Telephone Number : 714-978-6682
Fax Number :
Provider Business Practice Location Address
First Line : 238 S FLOWER ST
Second Line :
City : ORANGE
State : CA
Zip : 92868-3415
Country : US
Telephone Number : 714-978-6682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2019
Last Update Date : 01/29/2023

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Directions to “ STEPHANIE ANN GAMBLIN ” Practice Location

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