Provider Information for 1578594313
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Dr. CAROL LYNN GANDOLFO Psy D
Sex: Female
NPI: 1578594313
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
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NPI | 1578594313 | ||||||||
Enumeration Date | 2006-07-06 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 1600 9TH STREET ROOM 205 MAILSTOP 2-3 SACRAMENTO, CA 95814-6414 United States Phone: 916-654-2431 | Fax:916-654-3186 | ||||||||
Primary Practice Address | 3530 WEST POMONA BLVD POMONA, CA 91769-0100 United States Phone: 909-595-1221 | Fax: | ||||||||
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