Individual
GAYLE FENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2625 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 939-8585
(925) 933-2709
Mailing address
PO BOX 31396, WALNUT CREEK, CA 94598-8396
(925) 939-8585
(925) 933-2709
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
52252
CA
363AS0400X
Surgical Physician Assistant
Primary
52252
CA
Other
Enumeration date
01/16/2015
Last updated
01/12/2021
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