Gisela Bandera
Licensed Psychiatric Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1588313951
StatusActive
Last updated in NPPESSep 12, 2023
Details
- NPI
- 1588313951
- Entity type
- Individual (NPI-1)
- Name
- Gisela Bandera
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 22, 2022
- Certification date
- Sep 12, 2023
- Last updated
- Sep 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 167G00000X | Licensed Psychiatric Technician | PT41609 | CA | Yes |
Practice location
10717 Camino Ruiz Ste 207San Diego, CA 92126-2364
Phone 858-695-2211
Mailing address
10717 Camino Ruiz Ste 207San Diego, CA 92126-2364
Phone 858-695-2211
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