NPIMap

Organization Active NPI

Priest NP Services

  • Gerontology Nurse Practitioner
  • Novato, CA
National Provider Identifier
1306905336
Registry record updated Mar 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
284559 Issued in CA
Legal business name
PRIEST NP SERVICES
Practice address
750 Grant Ave
Suite 150
Novato, CA 94945-7001
Phone
(415) 899-9800
Fax
(415) 899-9805
NPI assigned
Dec 6, 2006
Last updated
Mar 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2008

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

Authorized official

Name
Debra Bakerjian, PHD, FNPNPI 1306872544
Title
Ceo Owner
Phone
(415) 899-9800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 284559 CA Primary
Gerontology Nurse Practitioner 363LG0600X 385529 CA
Gerontology Nurse Practitioner 363LG0600X 443622 CA
Gerontology Nurse Practitioner 363LG0600X 169169 CA
Gerontology Nurse Practitioner 363LG0600X 312821 CA
Gerontology Nurse Practitioner 363LG0600X 514203 CA
Gerontology Nurse Practitioner 363LG0600X 484393 CA

Addresses

Primary practice location

750 Grant Ave
Suite 150
Novato, CA 94945-7001

Mailing address

750 Grant Ave
Suite 150
Novato, CA 94945-7001
Phone (415) 899-9800

Other identifiers 1

IdentifierTypeStateIssuer
GNP000100MedicaidCA

National Provider Directory

National Provider Directory

Locations

750 Grant Ave
Ste 150
Novato, CA 94945
Phone (415) 899-9600

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206144000000",
    "number": "1306905336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 GRANT AVE",
            "address_2": "SUITE 150",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949457001",
            "telephone_number": "415-899-9800",
            "fax_number": "415-899-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 GRANT AVE",
            "address_2": "SUITE 150",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949457001",
            "telephone_number": "415-899-9800",
            "fax_number": "415-899-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIEST NP SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-03-22",
        "status": "A",
        "authorized_official_last_name": "BAKERJIAN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CEO OWNER",
        "authorized_official_telephone_number": "415-899-9800",
        "authorized_official_credential": "PHD,  FNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "284559",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "385529",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "443622",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "169169",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "312821",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "514203",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "484393",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GNP000100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2008; 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.