Provider Demographics
NPI:1902582539
Name:CHEN, GABRIELLE SANDAMIN
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:SANDAMIN
Last Name:CHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3662 MONTEGO DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-2004
Mailing Address - Country:US
Mailing Address - Phone:714-944-7731
Mailing Address - Fax:
Practice Address - Street 1:3662 MONTEGO DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-2004
Practice Address - Country:US
Practice Address - Phone:714-944-7731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula