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General NPI Number Information
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NPI Number | 1427135607
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Entity Type | Individual
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Provider Name | DONALD MARC GERSHBERG MA MFT
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 4281 KATELLA AVE SUITE226
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3500
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Country | US
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Telephone | 818-203-5531
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Fax | 323-478-0299
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Provider Business Mailing Address
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Address Line | 1539 W GARVEY AVE N SCPMG
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City | WEST COVINA
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State | CA
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Zip | 91790-2139
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Country | US
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Telephone | 626-856-3095
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Fax | 626-856-3078
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 41176
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License Number State | CA
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