Provider Demographics
NPI:1891915211
Name:GALE, BRUCE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
Last Name:GALE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16430 VENTURA BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2135
Mailing Address - Country:US
Mailing Address - Phone:818-788-2100
Mailing Address - Fax:
Practice Address - Street 1:16430 VENTURA BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2135
Practice Address - Country:US
Practice Address - Phone:818-788-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10598103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X, 103TH0100X, 103TM1800X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy