Provider Demographics
NPI:1558492504
Name:GILBERT, DORA (PSYD, MFT)
Entity Type:Individual
Prefix:MRS
First Name:DORA
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PSYD, MFT
Other - Prefix:MRS
Other - First Name:DORI
Other - Middle Name:
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, MFT
Mailing Address - Street 1:6564 BLUEFIELD PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-3210
Mailing Address - Country:US
Mailing Address - Phone:619-287-2242
Mailing Address - Fax:
Practice Address - Street 1:4080 CENTRE ST STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2655
Practice Address - Country:US
Practice Address - Phone:619-543-9850
Practice Address - Fax:619-543-9491
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50132106H00000X
CAMFC50132106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist