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1710100508
DE VIDA GILL
TUSTIN, CA
NPI
1710100508
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS 23243)
Enumeration Date
2007-04-10
Last Update Date
2020-01-31
Business Address
Dr. DE VIDA GILL LCSW
180 E MAIN ST STE 203
TUSTIN, CA 92780-4414
Phone number: 949-682-2092
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Mailing Address
Dr. DE VIDA GILL LCSW
2913 EL CAMINO REAL # 129
TUSTIN, CA 92782-8909
Phone number: 949-682-2092
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