Provider Demographics
NPI:1447650908
Name:GAUTHIER-PIN, SUZANNE (LMFT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:GAUTHIER-PIN
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 1:655 DEEP VALLEY DR STE 220
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3661
Mailing Address - Country:US
Mailing Address - Phone:310-936-1324
Mailing Address - Fax:
Practice Address - Street 1:655 DEEP VALLEY DR STE 220
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3661
Practice Address - Country:US
Practice Address - Phone:310-936-1324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-02
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT122628106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist