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ANTONIO GALLARDO

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1811321433

Individual Registrant:
 ANTONIO  GALLARDO 
Gender: M
Sole Proprietor

Location and contact information for practice:
216A SWETT RD  WOODSIDE, CA 94062-4752 US
Tel: 650-679-4475  Fax: --

Contact information for business:
PO BOX 6371  SAN MATEO, CA 94403-6371 US
Tel: 650-679-4475  Fax: --

Registration Information:
NPI: 1811321433
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
CA75166

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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