Healthcare Provider Details

I. General information

NPI: 1629312160
Provider Name (Legal Business Name): GAIL NORRINE LIGUORE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2012
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 N 13TH ST STE 200
GROVER BEACH CA
93433-5235
US

IV. Provider business mailing address

PO BOX 1316
PISMO BEACH CA
93448-1316
US

V. Phone/Fax

Practice location:
  • Phone: 661-204-8848
  • Fax:
Mailing address:
  • Phone: 661-204-8848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number45683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: