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Individual
DR. JACQUELINE MICHELLE GAMBOA
Active
Individual
DR. JACQUELINE MICHELLE GAMBOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY22784
CA
103TC0700X
Clinical Psychologist
Primary
PSY22784
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY22784
CA
103TF0000X
Family Psychologist
PSY22784
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PSY22784
CA
Other
Enumeration date
09/23/2009
Last updated
06/03/2010
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