Provider Demographics
NPI:1861612582
Name:GALLARDO, GLORIA SAPIEN
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:SAPIEN
Last Name:GALLARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:SAPIEN
Other - Last Name:GALLARDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2915 N WEST AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-3903
Mailing Address - Country:US
Mailing Address - Phone:559-228-1147
Mailing Address - Fax:
Practice Address - Street 1:4944 E CLINTON WAY STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1527
Practice Address - Country:US
Practice Address - Phone:559-251-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)