Healthcare Provider Details

I. General information

NPI: 1417771742
Provider Name (Legal Business Name): SHEILA SOLDIVILLO GILBERT MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 S PACIFIC COAST HWY STE 205
REDONDO BEACH CA
90277-7036
US

IV. Provider business mailing address

632 AVENUE A
REDONDO BEACH CA
90277-4811
US

V. Phone/Fax

Practice location:
  • Phone: 424-622-8842
  • Fax:
Mailing address:
  • Phone: 949-677-6290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: