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NPI 1629622766

NPI 1629622766 : TERRA GAUTHIER LMFT : SAN FRANCISCO, CA

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General NPI Number Information
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    NPI Number           |    1629622766
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    Entity Type          |    Individual 
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    Provider Name        |    TERRA GAUTHIER LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/26/2019
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    Last Update Date     |    01/27/2026
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Provider Practice Location Address
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    Address Line         |    1515 QUINTARA ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94116-1273
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    Country              |    US
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    Telephone            |    415-242-2615
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1515 QUINTARA ST 
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    City                 |    SAN FRANCISCO
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    State                |    CA
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    Zip                  |    94116-1273
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    Country              |    US
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    Telephone            |    415-242-2615
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    44354
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    44354
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    License Number State |    CA
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