| Doctor Name: | DR. BRUCE WHYDDON GLADSTONE |
| NPI Number: | 1295812659 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PSY6173 |
| Business Practice Address: | 530 W Ojai Ave Suite 208 Ojai, CA - 930232462 |
| Business Phone Number: | 8056469724 |
| Business Fax Number: | 8056461387 |
| Mailing Address: | 530 W Ojai Ave, Suite 208 OJAI |
| State: | CA |
| Postal Code: | 930232462 |
| Phone Number: | 8056469724 |
| Fax Number: | 8056461387 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | PSY6173 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |