Provider Demographics
NPI:1558402610
Name:PINTO, GAYNE ANNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:GAYNE
Middle Name:ANNE
Last Name:PINTO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:957 LAUREATE LN
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-7881
Mailing Address - Country:US
Mailing Address - Phone:805-546-0662
Mailing Address - Fax:805-546-0662
Practice Address - Street 1:957 LAUREATE LN
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-7881
Practice Address - Country:US
Practice Address - Phone:805-546-0662
Practice Address - Fax:805-546-0662
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC8723106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist