Gayle Whitlock

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

84009 Issued in CA

Practice address

429 Speers Rd
Santa Rosa, CA 95409-3123

Phone

(707) 571-2215

Fax

(707) 526-9672

NPI assigned

Jul 26, 2010

Last updated

Oct 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Leaf Counseling and Psychotherapy

  • Marriage & Family Therapist
  • Santa Rosa, CA
  • NPI 1366940504
  NPD Authorized official
• R House, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Rosa, CA
  • NPI 1760516702
  NPD (past)

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1639483167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2587",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954050587",
            "telephone_number": "707-571-2215",
            "fax_number": "707-526-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 SPEERS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093123",
            "telephone_number": "707-571-2215",
            "fax_number": "707-526-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "GAYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "84009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tesheima White, MS, BCBA
• Lydia Pearl Whitebear
• Alison Whitemore
• Kasia Whiting, PHARMD
• Katherine Whitley
• Lucy Whitney
• Derek Edward Whittington, CATC IV
• John William Wickenburg, P.T.
• Margaret Wideau
• Derek Widener, PTA

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, 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 Oct 18, 2024; 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.