Provider Demographics
NPI:1871009233
Name:KAMINSKY, GAYLE B (LMFT)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:B
Last Name:KAMINSKY
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 1:32840 PACIFIC COAST HWY
Mailing Address - Street 2:STE B
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3469
Mailing Address - Country:US
Mailing Address - Phone:949-354-7439
Mailing Address - Fax:
Practice Address - Street 1:32840 PACIFIC COAST HWY STE B
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3469
Practice Address - Country:US
Practice Address - Phone:949-354-7439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99756106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty