Provider Demographics
NPI:1649783739
Name:GILBERT MARRIAGE AND FAMILY COUNSELING SERVICES, A PROFESSIONAL CORP.
Entity type:Organization
Organization Name:GILBERT MARRIAGE AND FAMILY COUNSELING SERVICES, A PROFESSIONAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:ANGELE
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:760-420-8845
Mailing Address - Street 1:7668 EL CAMINO REAL # 104-155
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-7932
Mailing Address - Country:US
Mailing Address - Phone:760-420-8845
Mailing Address - Fax:
Practice Address - Street 1:43460 RIDGE PARK DR STE 200-C
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5518
Practice Address - Country:US
Practice Address - Phone:951-297-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-10
Last Update Date:2019-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty