Provider Demographics
NPI:1780490144
Name:GRISELDA GALVAN, PSYD, A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity type:Organization
Organization Name:GRISELDA GALVAN, PSYD, A PROFESSIONAL PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRISELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-844-5980
Mailing Address - Street 1:4647 LONG BEACH BLVD STE D3
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-6976
Mailing Address - Country:US
Mailing Address - Phone:310-844-5980
Mailing Address - Fax:
Practice Address - Street 1:4647 LONG BEACH BLVD STE D3
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-6976
Practice Address - Country:US
Practice Address - Phone:310-844-5980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty