Provider Demographics
NPI:1043674039
Name:PIERRE, GABRIELA (LAC)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:PIERRE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2658 ROSEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2635
Mailing Address - Country:US
Mailing Address - Phone:540-841-9966
Mailing Address - Fax:
Practice Address - Street 1:303 POTRERO ST STE 42-306
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2780
Practice Address - Country:US
Practice Address - Phone:831-459-6762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16453171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist