Ari Gordin

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

200 W Arbor Dr # Mc8465
San Diego, CA 92103-1911

Phone

(619) 543-5300

NPI assigned

Mar 22, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1023549946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10255 PRESILLA RD",
            "city": "SANTA ROSA VALLEY",
            "state": "CA",
            "postal_code": "930128886",
            "telephone_number": "805-302-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR # MC8465",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031911",
            "telephone_number": "619-543-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDIN",
        "first_name": "ARI",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ZZ",
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A172380",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Lynn Gorcey, LCSW
• Bruce Lane Gorden, MFT
• Valerie Gorden
• Julianna L Gorder, PSY.D.
• Neomi T Gordillo
• Gordon M Rick
• Gordon Schanzlin New Vision Institute, Inc. a Professional Medical Cor
• Alison Gordon
• Alison Nicole Gordon, MD
• Ayana Marie Gordon

• Student in an Organized Health Care Education/Training Program in San Diego, CA
• Providers in San Diego, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.