Provider Demographics
NPI:1922681980
Name:KABAYAHO NEPA, GADI
Entity type:Individual
Prefix:
First Name:GADI
Middle Name:
Last Name:KABAYAHO NEPA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 S MILLER ST STE 11
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6916
Mailing Address - Country:US
Mailing Address - Phone:831-251-5434
Mailing Address - Fax:
Practice Address - Street 1:1414 S MILLER ST STE 10
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6916
Practice Address - Country:US
Practice Address - Phone:805-735-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)