Provider Demographics
NPI:1255761847
Name:GANDIN, AMY E (LMFT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:E
Last Name:GANDIN
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 1:14140 VENTURA BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2774
Mailing Address - Country:US
Mailing Address - Phone:818-486-8889
Mailing Address - Fax:
Practice Address - Street 1:14140 VENTURA BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2774
Practice Address - Country:US
Practice Address - Phone:818-486-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40831106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist