Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan George Gerendas

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1881308146

Ethan George Gerendas is a Student in an Organized Health Care Education/Training Program in South Pasadena, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

205 Pasadena Ave
South Pasadena, CA 91030-2919
Phone: (323) 344-5536
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Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 151056 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1881308146
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 11, 2023
Last updated in NPPESNovember 1, 2024
Certification dateNovember 1, 2024
Mailing address205 Pasadena Ave, South Pasadena, CA 91030-2919

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