Doctor Name: | DR. ALLAN GERSON |
NPI Number: | 1710396262 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PSY3338 |
Business Practice Address: | 12520 Magnolia Blvd Ste 302 N Hollywood, CA - 916072353 |
Business Phone Number: | 8184168078 |
Business Fax Number: | 8189958358 |
Mailing Address: | 4935 Libbit Ave, ENCINO |
State: | CA |
Postal Code: | 914361205 |
Phone Number: | 8184168078 |
Fax Number: | 8189958358 |
NPI Enumeration Date: | 08/08/2014 |
NPI Last Update Date: | 08/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY3338 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |