Provider Demographics
NPI:1538393061
Name:GARBESI, MARY (MFT)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:GARBESI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 OAK ST
Mailing Address - Street 2:#3
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5155
Mailing Address - Country:US
Mailing Address - Phone:310-452-7921
Mailing Address - Fax:
Practice Address - Street 1:2314 OAK ST
Practice Address - Street 2:#3
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-5155
Practice Address - Country:US
Practice Address - Phone:310-452-7921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18854106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist