Provider Demographics
NPI:1376676106
Name:PARRA, GERARDO G (MFT)
Entity Type:Individual
Prefix:MR
First Name:GERARDO
Middle Name:G
Last Name:PARRA
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 MACHADO LN
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-8800
Mailing Address - Country:US
Mailing Address - Phone:310-737-9393
Mailing Address - Fax:
Practice Address - Street 1:5350 MACHADO LN
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-8800
Practice Address - Country:US
Practice Address - Phone:310-737-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist