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General NPI Number Information
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NPI Number | 1710396262
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Entity Type | Individual
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Provider Name | ALLAN GERSON PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 12520 MAGNOLIA BLVD STE 302
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City | N HOLLYWOOD
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State | CA
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Zip | 91607-2353
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Country | US
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Telephone | 818-416-8078
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Fax | 818-995-8358
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Provider Business Mailing Address
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Address Line | 4935 LIBBIT AVE
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City | ENCINO
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State | CA
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Zip | 91436-1205
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Country | US
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Telephone | 818-416-8078
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Fax | 818-995-8358
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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 | PSY3338
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License Number State | CA
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