Provider Demographics
NPI:1174647754
Name:GILBERT, EMILY CLAIRE (MFT)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:CLAIRE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11728 WILSHIRE BLVD APT B801
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6410
Mailing Address - Country:US
Mailing Address - Phone:310-386-6583
Mailing Address - Fax:
Practice Address - Street 1:12099 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5882
Practice Address - Country:US
Practice Address - Phone:310-751-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52890101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health