Basic Information
Provider Information
NPI: 1467183756
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CATIPON
FirstName: GABRIELLE
MiddleName: LAUREN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 2358 MADRUGADA DR
Address2:  
City: CHINO HILLS
State: CA
PostalCode: 917091369
CountryCode: US
TelephoneNumber: 9094380808
FaxNumber:  
Practice Location
Address1: 255 E BONITA AVE
Address2:  
City: POMONA
State: CA
PostalCode: 917671923
CountryCode: US
TelephoneNumber: 9095967733
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/18/2022
LastUpdateDate: 06/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0019X23393CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation

No ID Information.


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