Provider Demographics
NPI:1174881619
Name:DAVID, GUNILLA A (MFT)
Entity type:Individual
Prefix:
First Name:GUNILLA
Middle Name:A
Last Name:DAVID
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 1:9720 WILSHIRE BLVD
Mailing Address - Street 2:# 708
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2021
Mailing Address - Country:US
Mailing Address - Phone:310-229-5222
Mailing Address - Fax:818-508-7886
Practice Address - Street 1:9720 WILSHIRE BLVD
Practice Address - Street 2:# 708
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2021
Practice Address - Country:US
Practice Address - Phone:310-229-5222
Practice Address - Fax:818-508-7886
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC # 50678106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist