Provider Demographics
NPI:1548598956
Name:GRAY, ERIN DELIA (LMFT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:DELIA
Last Name:GRAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 KERNER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-4840
Mailing Address - Country:US
Mailing Address - Phone:415-473-3440
Mailing Address - Fax:415-473-6313
Practice Address - Street 1:3270 KERNER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-4840
Practice Address - Country:US
Practice Address - Phone:415-473-3440
Practice Address - Fax:415-473-6313
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84691106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist