Provider Demographics
NPI:1750457255
Name:GORDON, BELINDA DIANE (MSC, MFCT, RASI)
Entity Type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:DIANE
Last Name:GORDON
Suffix:
Gender:F
Credentials:MSC, MFCT, RASI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 10TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101
Mailing Address - Country:US
Mailing Address - Phone:619-239-4663
Mailing Address - Fax:619-239-3045
Practice Address - Street 1:734 10TH AVENUE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101
Practice Address - Country:US
Practice Address - Phone:619-239-4663
Practice Address - Fax:619-239-3045
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health