Provider Demographics
NPI:1710030994
Name:LOPES CUNHA, GARY JOSEPH (LMFT)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:JOSEPH
Last Name:LOPES CUNHA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:GARY
Other - Middle Name:JOSEPH
Other - Last Name:CUNHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:2008 MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2135
Mailing Address - Country:US
Mailing Address - Phone:916-801-5951
Mailing Address - Fax:916-973-7495
Practice Address - Street 1:4070 BRIDGE ST
Practice Address - Street 2:SUITE #2
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7557
Practice Address - Country:US
Practice Address - Phone:916-801-5951
Practice Address - Fax:916-973-7495
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38310106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist