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Provider Information for 1700352606


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GABRIELLE VALENTINA GRAY LCSW


Sex: Female

NPI: 1700352606
Last Updated: 2023-05-04
Certification Date: 2023-05-04

Details

NameValue
NPI1700352606
Enumeration Date2018-10-17
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 8553 LARCH AVE
COTATI, CA 94931-4470
United States

Phone: 707-479-1911 | Fax:
 
Primary Practice Address 1855 2ND ST STE B
CONCORD, CA 94519-2623
United States

Phone: 855-223-7123 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalCA114621
No 106S00000X - Behavior Technician CARBT-18-67856