Provider Demographics
NPI:1891810420
Name:GREGSON, WENDY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:GREGSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE116
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2827
Mailing Address - Country:US
Mailing Address - Phone:805-446-6324
Mailing Address - Fax:
Practice Address - Street 1:1337 E THOUSAND OAKS BLVD
Practice Address - Street 2:SUITE116
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2827
Practice Address - Country:US
Practice Address - Phone:805-446-6324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31134106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist