Provider Demographics
NPI:1124047956
Name:GABRIEL, GINGER VIRGINIA (PHD, MFT)
Entity type:Individual
Prefix:DR
First Name:GINGER
Middle Name:VIRGINIA
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 FOREST SHADE DR.
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CRESTLINE
Mailing Address - State:CA
Mailing Address - Zip Code:92325-4425
Mailing Address - Country:US
Mailing Address - Phone:909-338-6968
Mailing Address - Fax:909-338-6086
Practice Address - Street 1:601 S LEE BERT WAY
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:CA
Practice Address - Zip Code:92325
Practice Address - Country:US
Practice Address - Phone:909-338-6968
Practice Address - Fax:909-338-6086
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31925106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist