Healthcare Provider Details

I. General information

NPI: 1770014623
Provider Name (Legal Business Name): JAMIE GELBART LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24445 HAWTHORNE BLVD STE 202
TORRANCE CA
90505-6562
US

IV. Provider business mailing address

22545 FERN ANN FALLS RD
CHATSWORTH CA
91311-1202
US

V. Phone/Fax

Practice location:
  • Phone: 310-257-5758
  • Fax:
Mailing address:
  • Phone: 310-257-5785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF91035
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: