Provider Demographics
NPI:1356535231
Name:GIMBEL, ERIKA L (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:L
Last Name:GIMBEL
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 DEAKIN ST # L
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1941
Mailing Address - Country:US
Mailing Address - Phone:415-820-1559
Mailing Address - Fax:
Practice Address - Street 1:3045 DEAKIN ST # L
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1941
Practice Address - Country:US
Practice Address - Phone:415-820-1559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48004106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist