Provider Demographics
NPI:1225216039
Name:GAZDAUGH, DORIS VALERIE (COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:VALERIE
Last Name:GAZDAUGH
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 CANBY ST.
Mailing Address - Street 2:#5
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335
Mailing Address - Country:US
Mailing Address - Phone:818-263-9494
Mailing Address - Fax:
Practice Address - Street 1:8604 LANKERSHIM BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3140
Practice Address - Country:US
Practice Address - Phone:818-768-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator