Provider Demographics
NPI:1871525089
Name:GAJ, LUCYNA IGA (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:LUCYNA
Middle Name:IGA
Last Name:GAJ
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:L.
Other - Middle Name:IGA
Other - Last Name:GAJ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MFT
Mailing Address - Street 1:PO BOX 9113
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90295-1513
Mailing Address - Country:US
Mailing Address - Phone:310-430-2701
Mailing Address - Fax:310-574-9415
Practice Address - Street 1:400 CORPORATE POINTE
Practice Address - Street 2:AUCC
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-7615
Practice Address - Country:US
Practice Address - Phone:310-430-2701
Practice Address - Fax:310-574-9415
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40850106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist