Provider Demographics
NPI:1316552482
Name:ZERMINO, GRISELDA (MENTAL HEALTH, LMFT)
Entity type:Individual
Prefix:MRS
First Name:GRISELDA
Middle Name:
Last Name:ZERMINO
Suffix:
Gender:F
Credentials:MENTAL HEALTH, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1977
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90733-1977
Mailing Address - Country:US
Mailing Address - Phone:424-327-5356
Mailing Address - Fax:
Practice Address - Street 1:222 W 6TH ST STE 400
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3345
Practice Address - Country:US
Practice Address - Phone:310-221-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120176106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA120176OtherBBS - LMFT