Provider Demographics
NPI:1922481829
Name:GABRIEL, NIKKI CARELLI (MFT)
Entity Type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:CARELLI
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17540 KINGSBURY ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-6027
Mailing Address - Country:US
Mailing Address - Phone:310-383-9229
Mailing Address - Fax:
Practice Address - Street 1:17540 KINGSBURY ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6027
Practice Address - Country:US
Practice Address - Phone:310-383-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83934106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist