Provider Demographics
NPI:1518005438
Name:GAMEROS, ELMA JEAN (MFTI)
Entity Type:Individual
Prefix:MS
First Name:ELMA
Middle Name:JEAN
Last Name:GAMEROS
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E LELAND RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-4960
Mailing Address - Country:US
Mailing Address - Phone:925-439-9628
Mailing Address - Fax:
Practice Address - Street 1:300 E LELAND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-4960
Practice Address - Country:US
Practice Address - Phone:925-439-9628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA910-1596-6101YM0800X
CA55505106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4744OtherCONTRA COSTA COUNTY PROVIDER NUMBER