MEDICARE: GABRIELA GARITA SALAS

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
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1740985241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA GARITA SALAS

Provider Business Mailing Address
First Line	:	816 W WASHINGTON AVE APT 5
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-3899
Country	:	US
Telephone Number	:	714-478-8211
Fax Number	:

Provider Business Practice Location Address
First Line	:	816 W WASHINGTON AVE APT 5
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-3899
Country	:	US
Telephone Number	:	714-478-8211
Fax Number	:

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

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	04/03/2023

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Directions to “ GABRIELA GARITA SALAS ” Practice Location

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