Provider Demographics
NPI:1689803009
Name:PICKARD, GABRIELLE (THERAPIST MFT)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:PICKARD
Suffix:
Gender:F
Credentials:THERAPIST MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20094 MISSION BLVD.
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541
Mailing Address - Country:US
Mailing Address - Phone:510-727-9755
Mailing Address - Fax:510-727-9761
Practice Address - Street 1:20094 MISSION BLVD.
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541
Practice Address - Country:US
Practice Address - Phone:510-727-9755
Practice Address - Fax:510-727-9761
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 16541106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist