Provider Demographics
NPI:1528109287
Name:BATES, GABRIEL JOHN (OTRL)
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:JOHN
Last Name:BATES
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SOLAR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2645
Mailing Address - Country:US
Mailing Address - Phone:805-604-1924
Mailing Address - Fax:805-604-0176
Practice Address - Street 1:2001 SOLAR DR
Practice Address - Street 2:SUITE 215
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2645
Practice Address - Country:US
Practice Address - Phone:805-604-1924
Practice Address - Fax:805-604-0176
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 491225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist