Provider Demographics
NPI:1154451102
Name:GOURRIER, GISELLE L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GISELLE
Middle Name:L
Last Name:GOURRIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 BUCKINGHAM PKWY
Mailing Address - Street 2:103
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7237
Mailing Address - Country:US
Mailing Address - Phone:310-338-0282
Mailing Address - Fax:
Practice Address - Street 1:12714 AVALON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-2730
Practice Address - Country:US
Practice Address - Phone:323-777-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health