Provider Demographics
NPI:1285901942
Name:GERSHELIS, ANNA (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:GERSHELIS
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17777 VENTURA BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3738
Mailing Address - Country:US
Mailing Address - Phone:213-445-2266
Mailing Address - Fax:
Practice Address - Street 1:17777 VENTURA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:213-445-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 287771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical