Individual
JULIE GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25352 HILLARY LN, LAGUNA HILLS, CA 92653-5217
(949) 412-1900
Mailing address
1001 AVENIDA PICO # C-474, SAN CLEMENTE, CA 92673-6957
(949) 412-1900
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/20/2015
Last updated
04/13/2017
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