MEDICARE: MRS. KATREENA EVELYN GAVRILA MS, PPS

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	101YS0200X	School Counselor	250262759	CA

General Provider Information

NPI Number	:	1942147780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATREENA EVELYN GAVRILA MS, PPS

Provider Business Mailing Address
First Line	:	33122 VALLE RD
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-4859
Country	:	US
Telephone Number	:	949-234-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	26462 VIA SACRAMENTO
Second Line	:
City	:	CAPISTRANO BEACH
State	:	CA
Zip	:	92624-1399
Country	:	US
Telephone Number	:	949-496-5942
Fax Number	:

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

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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