| Doctor Name: | MS. THERESE ANNE GIBSON |
| NPI Number: | 1023271541 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 17766 |
| Business Practice Address: | 1200 Harbor Dr N Unit 7c Oceanside, CA - 920541064 |
| Business Phone Number: | 7604202293 |
| Business Fax Number: | 7604332293 |
| Mailing Address: | 1200 Harbor Dr, No 7c OCEANSIDE |
| State: | CA |
| Postal Code: | 92054 |
| Phone Number: | 7604337304 |
| Fax Number: | 7604332293 |
| NPI Enumeration Date: | 07/03/2008 |
| NPI Last Update Date: | 07/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 17766 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |