Provider Demographics
NPI:1316118029
Name:GESSEL, ELIZABETH A (MFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:GESSEL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 RIVERSIDE DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2500
Mailing Address - Country:US
Mailing Address - Phone:818-640-8356
Mailing Address - Fax:
Practice Address - Street 1:13400 RIVERSIDE DR
Practice Address - Street 2:SUITE 310
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2500
Practice Address - Country:US
Practice Address - Phone:818-640-8356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFCC38999106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist