Provider Demographics
NPI:1831328681
Name:ROSSI-NEEDLEMAN, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:ROSSI-NEEDLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 ARTESIA BLVD
Mailing Address - Street 2:613
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3073
Mailing Address - Country:US
Mailing Address - Phone:310-376-3562
Mailing Address - Fax:
Practice Address - Street 1:2110 ARTESIA BLVD
Practice Address - Street 2:613
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3073
Practice Address - Country:US
Practice Address - Phone:310-376-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)