Provider Demographics
NPI:1043444698
Name:PRICE, GAIL (LMFT)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17772 IRVINE BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3256
Mailing Address - Country:US
Mailing Address - Phone:714-606-4401
Mailing Address - Fax:
Practice Address - Street 1:17772 IRVINE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3256
Practice Address - Country:US
Practice Address - Phone:714-606-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 18339106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist