Individual
GABRIELA PORTAN-ASCENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
195 GLEN COVE MARINA RD E, VALLEJO, CA 94591-7285
(707) 651-9915
Mailing address
195 GLEN COVE MARINA RD E, VALLEJO, CA 94591-7285
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
3927
CA
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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