Provider Demographics
NPI:1679827000
Name:GENSTLER, LEANE ELAINE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LEANE
Middle Name:ELAINE
Last Name:GENSTLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LEANE
Other - Middle Name:ELAINE
Other - Last Name:WINGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:444 PEARL STREET, C2
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-200-3375
Mailing Address - Fax:831-747-2668
Practice Address - Street 1:444 PEARL STREET, C2
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-200-3375
Practice Address - Fax:831-747-2668
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALMFT94201106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
BWASOCFSPOtherMEDI-CAL
41BWOtherMEDI-CAL