Ginger Virginia Gabriel, PH.D., M.F.T.

Individual provider Active NPI Marriage & Family Therapist · Crestline, CA

NPI 1124047956 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124047956
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC31925 (CA)
Practice address
601 S Lee Bert Way
Crestline, CA 92325
Phone
(909) 338-6968
Fax
(909) 338-6086
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC31925CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC31925 CA Yes

Addresses

Primary practice location

601 S Lee Bert Way
Crestline, CA 92325

Mailing address

580 Forest Shade Dr.
Suite 10
Crestline, CA 92325-4425
Phone (909) 338-6968

Other providers in Crestline, CA

All providers in Crestline, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.