Provider Demographics
NPI:1447454897
Name:GORSICH, ELIZABETH FRANCES (MFT)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:FRANCES
Last Name:GORSICH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 MOUNT BIGELOW DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2518
Mailing Address - Country:US
Mailing Address - Phone:858-565-2757
Mailing Address - Fax:858-565-2757
Practice Address - Street 1:3604 4TH AVE
Practice Address - Street 2:SSUITE 3
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4165
Practice Address - Country:US
Practice Address - Phone:619-685-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32839106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist