Provider Demographics
NPI:1780899419
Name:GELKER, CAROLE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:
Last Name:GELKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 OLIVE LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-1935
Mailing Address - Country:US
Mailing Address - Phone:714-543-3097
Mailing Address - Fax:
Practice Address - Street 1:1801 PARK COURT PL STE F203
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-5081
Practice Address - Country:US
Practice Address - Phone:714-667-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102L00000X
CAMK24198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist