Individual
BRUCE GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10605 BALBOA BLVD. SUITE 100, GRANADA HILLS, CA 91344
(818) 832-2400
Mailing address
121 W VICTORIA ST, LONG BEACH, CA 90805-2162
(310) 603-1030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
32704
CA
Other
Enumeration date
10/14/2009
Last updated
10/12/2012
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