Gabriella Azzam-Forni, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29357 Issued in CA

Practice address

10780 Santa Monica Blvd Ste 290
Los Angeles, CA 90025-4777

Phone

(424) 341-4224

NPI assigned

Jun 16, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1881008043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD STE 290",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254777",
            "telephone_number": "424-341-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD STE 290",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254777",
            "telephone_number": "424-341-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZAM-FORNI",
        "first_name": "GABRIELLA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024328",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29357",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ugochi Onuchi Azubuike, AGACNP
• Mercy Ekeoma Azubuko-Udah
• Daniel Orlando Azucar
• Jacqueline Lizzette Azucena
• Neil Lomeda Azul, RPH
• Huda Azzam
• Ramzi I Azzam, M.D., PH.D.
• Shadera Azzam, MSGH, RDN
• Dominic Azzariti
• Soraya Azzawi

• All providers in Los Angeles, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.