Provider Demographics
NPI:1306056098
Name:GABRIELSEN, JUDY HARRIS (NP, PA-C)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:HARRIS
Last Name:GABRIELSEN
Suffix:
Gender:F
Credentials:NP, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 CABERNET CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-9048
Mailing Address - Country:US
Mailing Address - Phone:559-999-6841
Mailing Address - Fax:559-739-1222
Practice Address - Street 1:1610 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4946
Practice Address - Country:US
Practice Address - Phone:559-625-8898
Practice Address - Fax:559-625-8010
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15998363A00000X
CA12827363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner