# DR. ERIC JON RAINEY GIBSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1528036761
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 00966 | IA | — |
| 103T00000X | Psychologist | HSP00445 | IA | — |
| 103TC0700X | Clinical Psychologist | 00966 | IA | — |
| 103TC0700X | Clinical Psychologist | HSP00445 | IA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 00966 | IA | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | HSP00445 | IA | — |

## Other

- **Enumeration date:** 03/14/2006
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1045898 | — | IA |
| 01 | — | 36432 | BLUE SHIELD | IA |
| 01 | — | IA0134 | JOHN DEERE HC | IA |