Provider Demographics
NPI:1316010291
Name:ZELTZER, GLORI R (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:GLORI
Middle Name:R
Last Name:ZELTZER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 SO. CALIFORNIA ST.
Mailing Address - Street 2:SUITE E
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001
Mailing Address - Country:US
Mailing Address - Phone:805-648-3535
Mailing Address - Fax:
Practice Address - Street 1:128 SO. CALIFORNIA ST.
Practice Address - Street 2:SUITE E
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001
Practice Address - Country:US
Practice Address - Phone:805-648-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT16587106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist