Provider Demographics
NPI:1114073921
Name:GASSNER, VERA (MFT)
Entity Type:Individual
Prefix:MS
First Name:VERA
Middle Name:
Last Name:GASSNER
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 1:2721 PARK BLVD.
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606
Mailing Address - Country:US
Mailing Address - Phone:510-816-1131
Mailing Address - Fax:510-835-1590
Practice Address - Street 1:1134 BALLENA BLVD.
Practice Address - Street 2:SUITE 18
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501
Practice Address - Country:US
Practice Address - Phone:510-816-1131
Practice Address - Fax:510-835-1590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CAMFC48791106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist