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Individual

DR. GLORIA JEAN GHANEM-YBARRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
32605 HIGHWAY 79 SOUTH, SUITE 202, TEMECULA, CA 92592
(760) 443-1355
Mailing address
PO BOX 892968, TEMECULA, CA 92589
(760) 443-1355

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY19964
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPL199640
TRICARE
CA
Enumeration date
10/03/2006
Last updated
07/08/2007
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