Provider Demographics
NPI:1043069636
Name:FONSECA STEENBOCK, GABRIELA III
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:FONSECA STEENBOCK
Suffix:III
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N DELAWARE ST APT 312
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-1523
Mailing Address - Country:US
Mailing Address - Phone:415-685-1831
Mailing Address - Fax:
Practice Address - Street 1:818 N DELAWARE ST APT 312
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-1523
Practice Address - Country:US
Practice Address - Phone:415-685-1831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula