Provider Demographics
NPI:1972730372
Name:GERO, PETER (MFT PHD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:GERO
Suffix:
Gender:M
Credentials:MFT PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 FOOTHILL BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2153
Mailing Address - Country:US
Mailing Address - Phone:213-399-4758
Mailing Address - Fax:
Practice Address - Street 1:1346 FOOTHILL BLVD STE 303
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-2153
Practice Address - Country:US
Practice Address - Phone:213-399-4758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 24438106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist