Provider Demographics
NPI:1114198389
Name:GILBERTSON, DAVID LLOYD (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LLOYD
Last Name:GILBERTSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 KALAKAUA AVE APT 1404
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1531
Mailing Address - Country:US
Mailing Address - Phone:808-264-2246
Mailing Address - Fax:
Practice Address - Street 1:1888 KALAKAUA AVE APT 1404
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1531
Practice Address - Country:US
Practice Address - Phone:808-264-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12629106H00000X
HI73106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist