Provider Demographics
NPI:1366628018
Name:GORSUCH, PAULETTE ANN (MFT)
Entity type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:ANN
Last Name:GORSUCH
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 1:39755 MURRIETA HOT SPRINGS ROAD
Mailing Address - Street 2:D160
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563
Mailing Address - Country:US
Mailing Address - Phone:951-588-3394
Mailing Address - Fax:951-723-2529
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS ROAD
Practice Address - Street 2:D160
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563
Practice Address - Country:US
Practice Address - Phone:951-588-3394
Practice Address - Fax:951-723-2529
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23459106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist