Provider Demographics
NPI:1902937774
Name:FREIRE, GABRIELLE MARIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:MARIE
Last Name:FREIRE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 EL NIDO DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-4529
Mailing Address - Country:US
Mailing Address - Phone:818-262-7598
Mailing Address - Fax:626-791-5548
Practice Address - Street 1:2933 EL NIDO DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-4529
Practice Address - Country:US
Practice Address - Phone:626-395-7100
Practice Address - Fax:626-791-5548
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45069106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist