Basic Information
| Provider Information | |||||||||
| NPI: | 1841313277 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILBERT | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | FRANCES | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10688 DESCHUTES RD | ||||||||
| Address2: | |||||||||
| City: | PALO CEDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960738775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302513875 | ||||||||
| FaxNumber: | 5302416541 | ||||||||
| Practice Location | |||||||||
| Address1: | 1614 CONTINENTAL ST | ||||||||
| Address2: | STE B | ||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960011133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302415999 | ||||||||
| FaxNumber: | 5302416541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2007 | ||||||||
| LastUpdateDate: | 05/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 20533 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.