Provider Demographics
NPI:1821206152
Name:BEKAERT, GILLES (MFT)
Entity Type:Individual
Prefix:
First Name:GILLES
Middle Name:
Last Name:BEKAERT
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 THE ALAMEDA
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1744
Mailing Address - Country:US
Mailing Address - Phone:408-382-1293
Mailing Address - Fax:
Practice Address - Street 1:1885 THE ALAMEDA
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1744
Practice Address - Country:US
Practice Address - Phone:408-382-1293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42826106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist