Provider Demographics
NPI:1932401445
Name:ANOBILE, GRACIELA E (NP)
Entity type:Individual
Prefix:MS
First Name:GRACIELA
Middle Name:E
Last Name:ANOBILE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25243 SHEPARDSON DR
Mailing Address - Street 2:APT. 3
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2926
Mailing Address - Country:US
Mailing Address - Phone:909-796-2157
Mailing Address - Fax:
Practice Address - Street 1:25243 SHEPARDSON DR
Practice Address - Street 2:APT. 3
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2926
Practice Address - Country:US
Practice Address - Phone:909-796-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA382579363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health