| Doctor Name: | MS. GAIL DOLORES JERIDEAU-PRATT |
| NPI Number: | 1154517092 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 459851 |
| Business Practice Address: | 30251 Channel Way Dr Canyon Lake, CA - 925877986 |
| Business Phone Number: | 9512462640 |
| Business Fax Number: | |
| Mailing Address: | 30251 Channel Way Dr, CANYON LAKE |
| State: | CA |
| Postal Code: | 925877986 |
| Phone Number: | 9512462640 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2007 |
| NPI Last Update Date: | 09/24/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 459851 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |