Doctor Name: | MRS. GLORIA PATRICIA AYALA-BRISCOE |
NPI Number: | 1609033737 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, ASW |
License Number: | |
Business Practice Address: | 445 N San Joaquin St Stockton, CA - 952022026 |
Business Phone Number: | 2094448910 |
Business Fax Number: | 2094448905 |
Mailing Address: | 445 S. San Joaquin Street, STOCKTON |
State: | CA |
Postal Code: | 95202 |
Phone Number: | 2094448910 |
Fax Number: | 2094448905 |
NPI Enumeration Date: | 05/16/2008 |
NPI Last Update Date: | 02/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |