Individual
MS. NINA GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 MONTEREY AVE, BERKELEY, CA 94707-2525
(510) 919-5058
Mailing address
1804 MONTEREY AVE, BERKELEY, CA 94707-2525
(510) 919-5058
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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