Provider Demographics
NPI:1649156050
Name:GALLEGOS, GENA MARIE (ACC)
Entity type:Individual
Prefix:
First Name:GENA
Middle Name:MARIE
Last Name:GALLEGOS
Suffix:
Gender:F
Credentials:ACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3524
Mailing Address - Country:US
Mailing Address - Phone:530-205-5418
Mailing Address - Fax:
Practice Address - Street 1:1096 HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3524
Practice Address - Country:US
Practice Address - Phone:530-205-5418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach