Provider Demographics
NPI:1023136728
Name:GIMELFARB, LEONID (PSY D)
Entity type:Individual
Prefix:DR
First Name:LEONID
Middle Name:
Last Name:GIMELFARB
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6517 KESTER AVE
Mailing Address - Street 2:SUIT #8
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1436
Mailing Address - Country:US
Mailing Address - Phone:323-974-5511
Mailing Address - Fax:818-509-8258
Practice Address - Street 1:6517 KESTER AVE
Practice Address - Street 2:SUIT #8
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1436
Practice Address - Country:US
Practice Address - Phone:323-974-5511
Practice Address - Fax:818-509-8258
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health