Individual
GINA MORCILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, PA-C
Contact information
Practice address
1425 S MAIN ST, WALNUT CREEK, CA 94596-5318
(925) 295-4000
Mailing address
1425 S MAIN ST, WALNUT CREEK, CA 94596-5318
(925) 295-4000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86073086
CA
363A00000X
Physician Assistant
Primary
PA64173
CA
363AS0400X
Surgical Physician Assistant
PA64173
CA
Other
Enumeration date
02/01/2021
Last updated
03/30/2024
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