Organization
GRETCHEN KUBACKY, PSY.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRETCHEN KUBACKY PSY.D. (OWNER/PRESIDENT)
(310) 625-6083
Entity
Organization
Contact information
Practice address
10883 ARIZONA AVENUE, CULVER CITY, CA 90232
(310) 625-6083
Mailing address
10883 ARIZONA AVENUE, CULVER CITY, CA 90232
(310) 625-6083
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY21917
CA
Other
Enumeration date
08/07/2012
Last updated
11/17/2022
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