Provider Demographics
NPI:1548353824
Name:GILL-DESBROW, LUNDA LUCINDA (MFT, EDD)
Entity type:Individual
Prefix:DR
First Name:LUNDA
Middle Name:LUCINDA
Last Name:GILL-DESBROW
Suffix:
Gender:F
Credentials:MFT, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261607
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91426-1607
Mailing Address - Country:US
Mailing Address - Phone:818-968-5207
Mailing Address - Fax:818-788-7739
Practice Address - Street 1:10506 BURBANK BLVD STE 202
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-2218
Practice Address - Country:US
Practice Address - Phone:818-968-5207
Practice Address - Fax:818-475-1471
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27190106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist