Doctor Name: | JOVA GAMBOA |
NPI Number: | 1750529624 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED |
License Number: | S98086223 |
Business Practice Address: | 105 Victory Rd Dorchester, MA - 021223518 |
Business Phone Number: | 6173713010 |
Business Fax Number: | |
Mailing Address: | 19 Chestnut St Apt 1, HYDE PARK |
State: | MA |
Postal Code: | 021361509 |
Phone Number: | 9782352813 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2009 |
NPI Last Update Date: | 01/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | S98086223 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |