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General NPI Number Information
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NPI Number | 1023593365
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Entity Type | Individual
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Provider Name | GABRIELLE DUCSAY PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 1015 FREMONT AVE
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-3224
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Country | US
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Telephone | 424-239-9470
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Fax |
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Provider Business Mailing Address
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Address Line | 945 5TH AVE APT 17E
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City | NEW YORK
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State | NY
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Zip | 10021-2667
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Country | US
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Telephone | 310-895-5252
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 30346
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License Number State | CA
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