Individual
GABRIEL PETER PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 N NORMA ST STE 133, RIDGECREST, CA 93555-2577
(760) 382-3589
Mailing address
1400 N NORMA ST STE 133, RIDGECREST, CA 93555-2577
(760) 382-3589
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
12/19/2024
Last updated
03/17/2025
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