Provider Demographics
NPI:1104944941
Name:GASTON-CRUZ, SHEILA MARIE (MS, PPS)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:MARIE
Last Name:GASTON-CRUZ
Suffix:
Gender:F
Credentials:MS, PPS
Other - Prefix:MRS
Other - First Name:SHEILA
Other - Middle Name:MARIE
Other - Last Name:LEMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, PPS
Mailing Address - Street 1:1661 N RAYMOND AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1120
Mailing Address - Country:US
Mailing Address - Phone:714-966-8683
Mailing Address - Fax:
Practice Address - Street 1:1661 N RAYMOND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1120
Practice Address - Country:US
Practice Address - Phone:714-966-8683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health