Provider Demographics
NPI:1053480400
Name:GIL, ELIZABETH V (MFT, PSY D)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:V
Last Name:GIL
Suffix:
Gender:F
Credentials:MFT, PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8716
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91372-8716
Mailing Address - Country:US
Mailing Address - Phone:818-876-0174
Mailing Address - Fax:
Practice Address - Street 1:4768 PARK GRANADA STE 102
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1548
Practice Address - Country:US
Practice Address - Phone:818-876-0174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34515106H00000X
CAPSY24007103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist