Basic Information
| Provider Information | |||||||||
| NPI: | 1669695599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANCO | ||||||||
| FirstName: | GILBERT | ||||||||
| MiddleName: | ERNEST | ||||||||
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| Credential: | MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 551 | ||||||||
| Address2: | |||||||||
| City: | BONITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194284463 | ||||||||
| FaxNumber: | 6194287952 | ||||||||
| Practice Location | |||||||||
| Address1: | 9628 CAMPO ROAD | ||||||||
| Address2: | SUITE M | ||||||||
| City: | SPRING VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91977 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194468096 | ||||||||
| FaxNumber: | 6194287952 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 08/02/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | B8238202 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 50841 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.