Provider Demographics
NPI:1063167153
Name:GAMBINI, LEDETTE (LMFT)
Entity type:Individual
Prefix:
First Name:LEDETTE
Middle Name:
Last Name:GAMBINI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 NORWICH AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3010
Mailing Address - Country:US
Mailing Address - Phone:323-401-5149
Mailing Address - Fax:
Practice Address - Street 1:1021 E WALNUT ST STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1485
Practice Address - Country:US
Practice Address - Phone:323-401-5149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118716106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist