Individual provider · NPI-1

Gabriella Ann Broda

Community Health Worker · Roseville, CA

NPI number1548091887
StatusActive
Last updated in NPPESApr 21, 2025

Details

NPI
1548091887
Entity type
Individual (NPI-1)
Name
Gabriella Ann Broda
Sex
Female
Sole proprietor
No
Enumeration date
Aug 9, 2024
Certification date
Apr 21, 2025
Last updated
Apr 21, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
172V00000X Community Health Worker––Yes
373H00000X Day Training/Habilitation Specialist––

Practice location

101 Cirby Hills Dr
Roseville, CA 95678-4360

Phone 530-301-4493

Mailing address

101 Cirby Hills Dr
Roseville, CA 95678-4360

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