Individual provider · NPI-1

Gabrielle A Acosta

Technician, Other · San Leandro, CA

NPI number1104414317
StatusActive
Last updated in NPPESJan 4, 2021

Details

NPI
1104414317
Entity type
Individual (NPI-1)
Name
Gabrielle A Acosta
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 4, 2021
Certification date
Jan 4, 2021
Last updated
Jan 4, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other––Yes

Practice location

1880 Fairway Dr
San Leandro, CA 94577-5629

Phone 916-729-3098

Mailing address

1932 E St
Hayward, CA 94541-5420

Phone 408-691-4644

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