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Dr. Cecille M Gannon, PSYD
Student in an Organized Health Care Education/Training Program in Sebastopol, California
NPI 1588855696

Cecille M Gannon is a Student in an Organized Health Care Education/Training Program based in Sebastopol, CA. Cecille M Gannon practices in Sebastopol, CA and has the professional credentials of PSYD. The NPI Number for Cecille M Gannon is 1588855696 and holds a License No. (California).

The current practice location address for Cecille M Gannon is 874 Gravenstein Ave, Sebastopol, CA and can be reached out via phone at 707-326-6609.

Location: 874 Gravenstein Ave, Sebastopol, CA, 95472-4555
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588855696
Provider Name
Cecille M Gannon
Credential
PSYD
Provider Entity Type
Individual
Gender
Female
Address
874 Gravenstein Ave, Sebastopol, CA, 95472-4555
Phone Number
707-326-6609
Fax Number
Provider Enumeration Date
08/05/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
874 Gravenstein Ave
City
Sebastopol
State
California
Zip
95472-4555
Phone Number
707-326-6609
Fax Number
person
Provider Business Mailing Address Details
Address
874 Gravenstein Ave
City
Sebastopol
State
California
Zip
95472-4555
Phone Number
707-326-6609
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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