Healthcare Provider Details

I. General information

NPI: 1134362882
Provider Name (Legal Business Name): CATHY MARIE GELFUSO MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2009
Last Update Date: 04/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15233 VENTURA BLVD SUITE #1204
SHERMAN OAKS CA
91403-2201
US

IV. Provider business mailing address

15233 VENTURA BLVD SUITE #1204
SHERMAN OAKS CA
91403-2201
US

V. Phone/Fax

Practice location:
  • Phone: 818-508-7183
  • Fax:
Mailing address:
  • Phone: 818-508-7183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC27815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: