Provider Demographics
NPI:1558546606
Name:GERTEL, YEHUDA SIMCHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:YEHUDA
Middle Name:SIMCHA
Last Name:GERTEL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9008 CASHIO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3310
Mailing Address - Country:US
Mailing Address - Phone:310-430-1151
Mailing Address - Fax:
Practice Address - Street 1:9008 CASHIO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-3310
Practice Address - Country:US
Practice Address - Phone:310-430-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist