Individual provider Active NPI

Loren Gerstein, PH.D.

  • Clinical Psychologist
  • Santa Rosa, CA
National Provider Identifier
1366574139
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15737 Issued in CA
Practice address
633 Cherry St
Santa Rosa, CA 95404-4202
Phone
(707) 706-3288
Fax
(707) 576-7875
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY15737 CA Primary

Addresses

Primary practice location

633 Cherry St
Santa Rosa, CA 95404-4202

Mailing address

633 Cherry St
Santa Rosa, CA 95404-4202
Phone (707) 706-3288

Other identifiers 1

IdentifierTypeStateIssuer
11701062OtherCACAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2017 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY15737CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp PastSince Aug 1, 2002 Accepting new patients

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1366574139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044202",
            "telephone_number": "707-706-3288",
            "fax_number": "707-576-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044202",
            "telephone_number": "707-706-3288",
            "fax_number": "707-576-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSTEIN",
        "first_name": "LOREN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11701062",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.