Provider Demographics
NPI:1568124642
Name:VEST, GENTRY (AMFT)
Entity type:Individual
Prefix:
First Name:GENTRY
Middle Name:
Last Name:VEST
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 STONEY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-8674
Mailing Address - Country:US
Mailing Address - Phone:925-400-8856
Mailing Address - Fax:
Practice Address - Street 1:11750 DUBLIN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2820
Practice Address - Country:US
Practice Address - Phone:925-400-8856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist