Provider Demographics
NPI:1598098915
Name:GEESTMAN, VANESSA
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:
Last Name:GEESTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 SANTA CARLOTTA ST
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2022
Mailing Address - Country:US
Mailing Address - Phone:818-621-1536
Mailing Address - Fax:
Practice Address - Street 1:11041 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2516
Practice Address - Country:US
Practice Address - Phone:626-442-4177
Practice Address - Fax:626-442-4498
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)