Provider Demographics
NPI:1598505117
Name:NAHLE, GABRIELLE NORA (AMFT)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:NORA
Last Name:NAHLE
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-1915
Mailing Address - Country:US
Mailing Address - Phone:323-690-3837
Mailing Address - Fax:
Practice Address - Street 1:934 HERMOSA AVE STE 11
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-4122
Practice Address - Country:US
Practice Address - Phone:323-690-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146977106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist