Provider Demographics
NPI:1588987879
Name:GASNER, GEORGIA FLORIN (MFTI, LMHC)
Entity type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:FLORIN
Last Name:GASNER
Suffix:
Gender:F
Credentials:MFTI, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 S ELISEO DR
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2005
Mailing Address - Country:US
Mailing Address - Phone:415-924-5995
Mailing Address - Fax:415-924-6837
Practice Address - Street 1:1251 S ELISEO DR
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2005
Practice Address - Country:US
Practice Address - Phone:415-924-5995
Practice Address - Fax:415-924-6837
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF60435106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist