Provider Demographics
NPI:1336900505
Name:BAIRD, URSULA GABEL (LMFT)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:GABEL
Last Name:BAIRD
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 1:3579 KELTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-5505
Mailing Address - Country:US
Mailing Address - Phone:310-489-6352
Mailing Address - Fax:
Practice Address - Street 1:3685 MOTOR AVE STE 220
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-5746
Practice Address - Country:US
Practice Address - Phone:424-262-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140454106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist