Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY27098 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY27098 | CA |
NPI | 1003015132 |
---|---|
Provider Name | Dr. Rethel E. Gill |
First Address | San Jose, CA 95131-2238 |
Second Address | San Jose, CA 95131-2238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2007 |
Last Update Date | 16/09/2020 |