Gaea Keridwyn Coon
Marriage & Family Therapist in Santa Rosa, CA. Individual provider (NPI-1).
NPI number1982135992
StatusActive
Last updated in NPPESJun 2, 2021
Details
- NPI
- 1982135992
- Entity type
- Individual (NPI-1)
- Name
- Gaea Keridwyn Coon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2017
- Certification date
- Jun 2, 2021
- Last updated
- Jun 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 102196 | CA | Yes |
| 106H00000X | Marriage & Family Therapist | – | – |
Practice location
850 3rd StSanta Rosa, CA 95404-4529
Phone 707-591-5766
Mailing address
5647 Raters DrSanta Rosa, CA 95409-4382
Phone 707-481-5033
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