Teri Lyn Gelgood, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT36536 Issued in CA

Practice address

493 Pleasant Valley Rd
Suite 200
Diamond Springs, CA 95667-5321

Phone

(530) 503-7040

NPI assigned

Oct 18, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1104015882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 INDIAN WELLS RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678103",
            "telephone_number": "530-503-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 PLEASANT VALLEY RD",
            "address_2": "SUITE 200",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956675321",
            "telephone_number": "530-503-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELGOOD",
        "first_name": "TERI",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT36536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Diamond Springs, CA
• Providers in Diamond Springs, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.