Individual
DR. JOHANNA D GLADIEUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
954 RISA RD STE A, LAFAYETTE, CA 94549-3418
(510) 332-0329
Mailing address
835 TOPPER LN, LAFAYETTE, CA 94549-5119
(925) 283-9953
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY4858
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE059A
MEDICARE PTAN
CA
Enumeration date
07/06/2006
Last updated
11/10/2009
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