Individual
MARISELA GIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(279) 842-3196
Mailing address
2085 RUSTIN AVE, RIVERSIDE, CA 92507-2498
(279) 842-3196
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
MPSS-PBICHQ
CA
Other
Enumeration date
08/08/2022
Last updated
03/20/2023
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