Organization
GARY VENTIMIGLIA MFCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY VENTIMIGLIA (SUPERVISOR)
(818) 497-8000
Entity
Organization
Contact information
Practice address
17356 SHERMAN WAY, VAN NUYS, CA 91406-3502
(818) 497-8000
Mailing address
17356 SHERMAN WAY, VAN NUYS, CA 91406-3502
(818) 497-8000
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
MFT21132
CA
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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