| Doctor Name: | JUDITH ELAINE GERSON |
| NPI Number: | 1023483849 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | EDD |
| License Number: | PSY 18061 |
| Business Practice Address: | 11824 Moorpark St Unit G Studio City, CA - 916042194 |
| Business Phone Number: | 8187627044 |
| Business Fax Number: | 8187627044 |
| Mailing Address: | 11824 Moorpark St, Unit G STUDIO CITY |
| State: | CA |
| Postal Code: | 916042194 |
| Phone Number: | 8187627044 |
| Fax Number: | 8187627044 |
| NPI Enumeration Date: | 12/04/2015 |
| NPI Last Update Date: | 12/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 18061 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |