| Doctor Name: | DR. EDY GERETY |
| NPI Number: | 1104949114 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PSY19514 |
| Business Practice Address: | 1729 E Pine Ave Apt 5 El Segundo, CA - 902454456 |
| Business Phone Number: | 3106225835 |
| Business Fax Number: | |
| Mailing Address: | 1729 E Pine Ave Apt 5, EL SEGUNDO |
| State: | CA |
| Postal Code: | 902454456 |
| Phone Number: | 3106225835 |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 08/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY19514 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |