Provider Demographics
NPI:1396057634
Name:PATRICIA GIESELMAN MARRIAGE & FAMILY THERAPY INC.
Entity type:Organization
Organization Name:PATRICIA GIESELMAN MARRIAGE & FAMILY THERAPY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GIESELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:626-470-9834
Mailing Address - Street 1:37 AUBURN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-1844
Mailing Address - Country:US
Mailing Address - Phone:626-470-9834
Mailing Address - Fax:
Practice Address - Street 1:37 AUBURN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-1844
Practice Address - Country:US
Practice Address - Phone:626-470-9834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 25498106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty