Provider Demographics
NPI:1689016842
Name:ZELLMAN, GAIL L (PHD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:L
Last Name:ZELLMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 VENTURA BLVD
Mailing Address - Street 2:SUITE 317
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3103
Mailing Address - Country:US
Mailing Address - Phone:310-459-0367
Mailing Address - Fax:310-392-9790
Practice Address - Street 1:15300 VENTURA BLVD
Practice Address - Street 2:SUITE 317
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3103
Practice Address - Country:US
Practice Address - Phone:310-459-0367
Practice Address - Fax:310-392-9790
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11938103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist