Provider Demographics
NPI:1457370264
Name:GUNTHER, RANDI M (PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:M
Last Name:GUNTHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SHADOW LN
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-4129
Mailing Address - Country:US
Mailing Address - Phone:310-541-6691
Mailing Address - Fax:
Practice Address - Street 1:2075 PALOS VERDES DR N STE 218
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-3726
Practice Address - Country:US
Practice Address - Phone:310-325-3873
Practice Address - Fax:310-325-9302
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
CA13567103TC1900X
CA6498106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist