Provider Information for 1639693971
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Mr. JACK GERSHFELD LMFT
Sex: Male
NPI: 1639693971
Last Updated: 2023-06-13
Certification Date: 2023-06-13
Certification Date: 2023-06-13
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1639693971 | ||||||||
| Enumeration Date | 2017-07-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2246 N STATE COLLEGE BLVD FULLERTON, CA 92831-1361 United States Phone: 714-725-7121 | Fax: | ||||||||
| Primary Practice Address | 680 LANGSDORF DR STE 108 FULLERTON, CA 92831-3702 United States Phone: 714-725-7121 | Fax: | ||||||||
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