Provider Demographics
NPI:1720116742
Name:GILBERT, NANCY LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LYNN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9171 WILSHIRE BLVD
Mailing Address - Street 2:STE. 615
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5530
Mailing Address - Country:US
Mailing Address - Phone:310-485-8898
Mailing Address - Fax:
Practice Address - Street 1:9171 WILSHIRE BLVD
Practice Address - Street 2:STE. 615
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5530
Practice Address - Country:US
Practice Address - Phone:310-485-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19550103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent