Provider Demographics
NPI:1629103213
Name:GIESELMAN, PATRICIA LOUISE (MFT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LOUISE
Last Name:GIESELMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 AUBURN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-1844
Mailing Address - Country:US
Mailing Address - Phone:626-755-4765
Mailing Address - Fax:
Practice Address - Street 1:37 AUBURN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-1844
Practice Address - Country:US
Practice Address - Phone:626-755-4765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 25498106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist