Healthcare Provider Details

I. General information

NPI: 1568595387
Provider Name (Legal Business Name): MRS. GINA MICHELLE GALPERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91605-1615
US

IV. Provider business mailing address

8330 LANKERSHIM BLVD
NORTH HOLLYWOOD CA
91605-1615
US

V. Phone/Fax

Practice location:
  • Phone: 818-252-1400
  • Fax: 189-985-4297
Mailing address:
  • Phone: 818-252-1400
  • Fax: 189-985-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: