Individual provider Active NPI

Gerald Michael Ganancial Bejarin

  • Professional Counselor
  • San Leandro, CA
National Provider Identifier
1205436334
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC21768 Issued in CA
Practice address
400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Phone
(510) 352-9200
NPI assigned
Oct 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPCC21768 CA Primary
Professional Counselor 101YP2500X 8907 CA

Addresses

Primary practice location

400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962

Mailing address

400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Phone (510) 924-0548

Other practice location 1

545 Estudillo Ave
San Leandro, CA 94577-4611
Phone (510) 352-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPCC21768CAMDProfessional Counselor
8907CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stars Behavioral Health Group Mental Health Current Accepting new patients

Locations

400 Estudillo Ave
Ste 100
San Leandro, CA 94577
Phone (510) 352-9200

545 Estudillo Ave
San Leandro, CA 94577
Phone (510) 352-9200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1205436334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774962",
            "telephone_number": "510-924-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774962",
            "telephone_number": "510-352-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Estudillo Ave",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945774611",
            "country_code": "US",
            "telephone_number": "510-352-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEJARIN",
        "first_name": "GERALD MICHAEL",
        "middle_name": "GANANCIAL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC21768",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "8907",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.