Provider Demographics
NPI:1023466695
Name:GRAY, ERIKA A (LMFT 132373)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:A
Last Name:GRAY
Suffix:
Gender:F
Credentials:LMFT 132373
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-0223
Mailing Address - Country:US
Mailing Address - Phone:559-301-5586
Mailing Address - Fax:
Practice Address - Street 1:3436 DOCKERY AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-4512
Practice Address - Country:US
Practice Address - Phone:559-301-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist