Provider Demographics
NPI:1538270780
Name:GERBER, TERRY A (MFT)
Entity type:Individual
Prefix:MS
First Name:TERRY
Middle Name:A
Last Name:GERBER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 DEMURRAGE WAY
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630
Mailing Address - Country:US
Mailing Address - Phone:916-798-7895
Mailing Address - Fax:916-351-9759
Practice Address - Street 1:310 NATOMA ST.
Practice Address - Street 2:STE. 150
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630
Practice Address - Country:US
Practice Address - Phone:916-798-7895
Practice Address - Fax:916-351-9759
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF40466106H00000X
CAMFC46214106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist