Healthcare Provider Details

I. General information

NPI: 1891915211
Provider Name (Legal Business Name): BRUCE M. GALE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16430 VENTURA BLVD SUITE 107
ENCINO CA
91436-2135
US

IV. Provider business mailing address

16430 VENTURA BLVD SUITE 107
ENCINO CA
91436-2135
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-2100
  • Fax:
Mailing address:
  • Phone: 818-788-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY10598
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10598
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY10598
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY10598
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPSY10598
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPSY10598
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPSY10598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: