Provider Demographics
NPI:1750904066
Name:GAITE, EMER M (AGPCNP - BC)
Entity type:Individual
Prefix:
First Name:EMER
Middle Name:M
Last Name:GAITE
Suffix:
Gender:F
Credentials:AGPCNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1697 GREENYARD CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5844
Mailing Address - Country:US
Mailing Address - Phone:925-325-7825
Mailing Address - Fax:
Practice Address - Street 1:5179 LONE TREE WAY STE 505
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8689
Practice Address - Country:US
Practice Address - Phone:925-634-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567765163WC0400X
CA95024819363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WC0400XNursing Service ProvidersRegistered NurseCase Management