Provider Demographics
NPI:1689767113
Name:GORETSKY, ELIHU (MFT)
Entity Type:Individual
Prefix:MR
First Name:ELIHU
Middle Name:
Last Name:GORETSKY
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:MR
Other - First Name:ELIOTT
Other - Middle Name:
Other - Last Name:GORETSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:3048 OVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-6551
Mailing Address - Country:US
Mailing Address - Phone:818-636-0745
Mailing Address - Fax:760-295-1763
Practice Address - Street 1:3048 OVERHILL DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-6551
Practice Address - Country:US
Practice Address - Phone:818-636-0745
Practice Address - Fax:760-295-1763
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46560106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist