Doctor Name: | GINA VONLOSSBERG |
NPI Number: | 1063786788 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ACSW |
License Number: | ASW59873 |
Business Practice Address: | 1529 E Palmdale Blvd Palmdale, CA - 935502034 |
Business Phone Number: | 6612084242 |
Business Fax Number: | 6612242187 |
Mailing Address: | 1529 E Palmdale Blvd Ste 210, PALMDALE |
State: | CA |
Postal Code: | 935502029 |
Phone Number: | 6612084242 |
Fax Number: | 6612240438 |
NPI Enumeration Date: | 02/27/2012 |
NPI Last Update Date: | 11/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | ASW59873 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |