Provider Information for 1568588325
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Ms. RUTH ANNE GILLIS MC MFT
Sex: Female
NPI: 1568588325
Last Updated: 2018-03-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1568588325 | ||||||||
| Enumeration Date | 2007-03-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 9338 KENWOOD DR SPRING VALLEY, CA 91977-2424 United States Phone: 619-341-3747 | Fax:619-341-4737 | ||||||||
| Primary Practice Address | 1250 6TH AVE STE 100 SAN DIEGO, CA 92101-4368 United States Phone: 619-515-2430 | Fax: | ||||||||
| Secondary Practice Address(es) | 270 E DOUGLAS AVE | ||||||||
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