Provider Demographics
NPI:1871289983
Name:GLADSEASONSLIVING
Entity type:Organization
Organization Name:GLADSEASONSLIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THUY
Authorized Official - Middle Name:N
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-386-6624
Mailing Address - Street 1:1636 WATSON CT
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6822
Mailing Address - Country:US
Mailing Address - Phone:510-386-6624
Mailing Address - Fax:
Practice Address - Street 1:1636 WATSON CT
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6822
Practice Address - Country:US
Practice Address - Phone:510-386-6624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty