Provider Demographics
NPI:1609679281
Name:GENTLE HEALING TRAUMA PSYCHOTHERAPY
Entity type:Organization
Organization Name:GENTLE HEALING TRAUMA PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LMFT
Authorized Official - Prefix:
Authorized Official - First Name:NANCI
Authorized Official - Middle Name:HYUN RYUNG
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:510-500-5964
Mailing Address - Street 1:39812 MISSION BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3087
Mailing Address - Country:US
Mailing Address - Phone:510-366-8581
Mailing Address - Fax:
Practice Address - Street 1:39812 MISSION BLVD STE 106
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3087
Practice Address - Country:US
Practice Address - Phone:510-366-8581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty