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NPI Code Detail

MEDICARE: YOURIE GIBSON LICENSED MFT

MEDICARE: YOURIE GIBSON LICENSED MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist129530CA

General Provider Information

NPI Number : 1881107373
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOURIE GIBSON LICENSED MFT
Provider Business Mailing Address
First Line : 4100 WADE ST APT 7
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-5751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5731 W SLAUSON AVE STE 220
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6984
Country : US
Telephone Number : 888-851-5595
Fax Number : 888-231-5872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2017
Last Update Date : 03/03/2026

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Directions to “ YOURIE GIBSON LICENSED MFT” Practice Location

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