Healthcare Provider Details

I. General information

NPI: 1316010291
Provider Name (Legal Business Name): GLORI R. ZELTZER M.A., M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 SO. CALIFORNIA ST. SUITE E
VENTURA CA
93001
US

IV. Provider business mailing address

128 SO. CALIFORNIA ST. SUITE E
VENTURA CA
93001
US

V. Phone/Fax

Practice location:
  • Phone: 805-648-3535
  • Fax:
Mailing address:
  • Phone: 805-648-3535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT16587
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: