Provider Demographics
NPI:1669753562
Name:BERSI, AMBER CHRISTINE (LMFT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:CHRISTINE
Last Name:BERSI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:CHRISTINE
Other - Last Name:HIXON-GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:4531 MARKET ST STE E
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-8014
Mailing Address - Country:US
Mailing Address - Phone:805-258-3058
Mailing Address - Fax:
Practice Address - Street 1:4531 MARKET ST STE E
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-8014
Practice Address - Country:US
Practice Address - Phone:805-258-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 61402106H00000X
CALMFT86050106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist