Provider Demographics
NPI:1861525594
Name:GARIBALDI, GRACIELA MONICA (PSYD)
Entity type:Individual
Prefix:DR
First Name:GRACIELA
Middle Name:MONICA
Last Name:GARIBALDI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1727
Mailing Address - Country:US
Mailing Address - Phone:310-968-1949
Mailing Address - Fax:
Practice Address - Street 1:2200 PACIFIC COAST HWY
Practice Address - Street 2:SUITE 304A
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2757
Practice Address - Country:US
Practice Address - Phone:310-968-1949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS155061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical