Healthcare Provider Details

I. General information

NPI: 1043872906
Provider Name (Legal Business Name): GENTIANE TC TOPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14119 BUCHER AVE
SYLMAR CA
91342-1442
US

IV. Provider business mailing address

14119 BUCHER AVE
SYLMAR CA
91342-1442
US

V. Phone/Fax

Practice location:
  • Phone: 818-290-5307
  • Fax:
Mailing address:
  • Phone: 818-290-5307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT112282
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT158641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: