Provider Demographics
NPI:1346003357
Name:GOSSETT, ELIZABETH GRACE PFEIFFER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:GRACE PFEIFFER
Last Name:GOSSETT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:GRACE
Other - Last Name:PFEIFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1049 EL MONTE AVE
Mailing Address - Street 2:SUITE C #151
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2399
Mailing Address - Country:US
Mailing Address - Phone:805-341-4376
Mailing Address - Fax:
Practice Address - Street 1:2380 LAURA LN
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-4226
Practice Address - Country:US
Practice Address - Phone:805-341-4376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16944103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical