Healthcare Provider Details

I. General information

NPI: 1699917989
Provider Name (Legal Business Name): VALERIE MICHELLE GELB MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24953 PASEO DE VALENCIA STE 24B
LAGUNA HILLS CA
92653-4311
US

IV. Provider business mailing address

PO BOX 2281
LAGUNA HILLS CA
92654-2281
US

V. Phone/Fax

Practice location:
  • Phone: 949-751-7380
  • Fax:
Mailing address:
  • Phone: 949-751-7380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: