Provider Demographics
NPI:1780963587
Name:GEHRKE, ALLISON JANE
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JANE
Last Name:GEHRKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 CITRACADO PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6428
Mailing Address - Country:US
Mailing Address - Phone:760-294-9270
Mailing Address - Fax:760-294-9268
Practice Address - Street 1:625 CITRACADO PKWY
Practice Address - Street 2:SUITE 102
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6428
Practice Address - Country:US
Practice Address - Phone:760-294-9270
Practice Address - Fax:760-294-9268
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program