Individual provider Active NPI

Gregory W Gibson, MA, MFT

  • Marriage & Family Therapist
  • Stockton, CA
National Provider Identifier
1740534650
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC52371 Issued in CA
Practice address
1151 W Robinhood Dr
Suite A8
Stockton, CA 95207-5625
Phone
(209) 954-7650
NPI assigned
Oct 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC52371 CA Primary

Addresses

Primary practice location

1151 W Robinhood Dr
Suite A8
Stockton, CA 95207-5625

Mailing address

1151 W Robinhood Dr
Suite A8
Stockton, CA 95207-5625
Phone (209) 954-7650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC52371CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1740534650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 W ROBINHOOD DR",
            "address_2": "SUITE A8",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075625",
            "telephone_number": "209-954-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 W ROBINHOOD DR",
            "address_2": "SUITE A8",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075625",
            "telephone_number": "209-954-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "GREGORY",
        "middle_name": "W",
        "credential": "MA, MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC52371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.