Individual
DR. GAUTAMI POLEPALLY ASHOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 W CHAPMAN AVE STE 203, ORANGE, CA 92868-2863
(714) 488-4594
Mailing address
1234 W CHAPMAN AVE STE 203, ORANGE, CA 92868-2863
(714) 488-4594
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY31767
CA
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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