Healthcare Provider Details

I. General information

NPI: 1942905419
Provider Name (Legal Business Name): GABRIELLE SAMUELS MARRIAGE & FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11846 VENTURA BLVD STE 204
STUDIO CITY CA
91604-2620
US

IV. Provider business mailing address

11846 VENTURA BLVD STE 204
STUDIO CITY CA
91604-2620
US

V. Phone/Fax

Practice location:
  • Phone: 323-807-2870
  • Fax:
Mailing address:
  • Phone: 323-807-2870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. GABRIELLE B SAMUELS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LMFT
Phone: 323-807-2870