Provider Demographics
NPI:1548073992
Name:LARIS, GABRIELA DIAZ (MS COUNSELING, PPS)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:DIAZ
Last Name:LARIS
Suffix:
Gender:F
Credentials:MS COUNSELING, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:CA
Mailing Address - Zip Code:93625-2499
Mailing Address - Country:US
Mailing Address - Phone:559-907-8935
Mailing Address - Fax:
Practice Address - Street 1:701 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:CA
Practice Address - Zip Code:93625-2499
Practice Address - Country:US
Practice Address - Phone:559-907-8935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool