Provider Information for 1457845604
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
JON MICKEL GABRIEL LCSW
Sex: Male
NPI: 1457845604
Last Updated: 2024-05-07
Certification Date: 2023-11-01
Certification Date: 2023-11-01
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1457845604 | ||||||||||||||||
| Enumeration Date | 2018-06-20 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 2736 DAILY DR FALLBROOK, CA 92028-8072 United States Phone: 714-614-4887 | Fax: | ||||||||||||||||
| Primary Practice Address | 2736 DAILY DR FALLBROOK, CA 92028-8072 United States Phone: 714-614-4887 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||
| Other Identifiers |
| ||||||||||||||||
| Taxonomy |
|