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General NPI Number Information
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NPI Number | 1508686247
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Entity Type | Individual
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Provider Name | PAOLA GANCMAN LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 18455 BURBANK BLVD STE 212
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City | TARZANA
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State | CA
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Zip | 91356-2839
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Country | US
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Telephone | 818-920-8323
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Fax |
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Provider Business Mailing Address
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Address Line | 4624 HAYVENHURST AVE
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City | ENCINO
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State | CA
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Zip | 91436-3252
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Country | US
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Telephone | 310-991-4443
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 150484
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License Number State | CA
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