Staci Michelle Gaddis, is a
Rehabilitation Practitioner based in San Diego, California. Staci Michelle Gaddis is licensed to practice in * (Not Available) (license number ) and her current practice location is
409 Camino Del Rio S Ste Ite 201, San Diego, California. She can be reached at her office (for appointments etc.) via phone at
(619) 436-4020.
NPI number for Staci Michelle Gaddis is 1770213712 and her current mailing address is 409 Camino Del Rio S Ste Ite 201, San Diego, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1770213712.
Healthcare Provider's Profile
| Full Name | Staci Michelle Gaddis |
|---|
| Gender | Female |
|---|
| Speciality | Rehabilitation Practitioner |
|---|
| Location | 409 Camino Del Rio S Ste Ite 201, San Diego, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1770213712
- Provider Enumeration Date: 06/13/2022
- Last Update Date: 04/23/2025
Medical Identifiers
Medical identifiers for Staci Michelle Gaddis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1770213712 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 225400000X | Rehabilitation Practitioner | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Staci Michelle Gaddis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Staci Michelle Gaddis, 409 Camino Del Rio S Ste Ite 201, San Diego, CA 92108-3504 Ph: (619) 436-4020 | Staci Michelle Gaddis, 409 Camino Del Rio S Ste Ite 201, San Diego, CA 92108-3504 Ph: (619) 436-4020 |
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