Provider Demographics
NPI:1205398344
Name:LAMBERT, GERALD JAMES (MFT)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:JAMES
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:28 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-7127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1510 FASHION ISLAND BLVD STE 110
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-5043
Practice Address - Country:US
Practice Address - Phone:650-570-7273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107060106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist