Individual provider Active NPI

Rena Marie Gamino, M.S, PSYD

  • Clinical Psychologist
  • Bakersfield, CA
National Provider Identifier
1730329210
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33184 Issued in CA
Practice address
3628 Stockdale Hwy
Bakersfield, CA 93309-2153
Phone
(661) 322-1021
NPI assigned
Feb 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF59257 CA
Clinical Psychologist 103TC0700X 33184 CA Primary

Addresses

Primary practice location

3628 Stockdale Hwy
Bakersfield, CA 93309-2153

Mailing address

2737 W Cecil Ave
Delano, CA 93215-1821
Phone (661) 721-2345

Other names 1

  • Miss Rena Marie Vasquez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220916003176 CA Practitioner - Clinical Psychologist 4880079441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
IMF59257CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jul 25, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 25, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Corrections and Rehabilitation-Headquarters CurrentSince Feb 27, 2022 Accepting new patients
North Kern State Prison PastSince Feb 27, 2022 Accepting new patients

Locations

3733 San Dimas St
Ste 101
Bakersfield, CA 93301
Phone (800) 353-5400

2737 W Cecil Ave
Delano, CA 93215

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 5

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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1730329210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2737 W CECIL AVE",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932151821",
            "telephone_number": "661-721-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 STOCKDALE HWY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933092153",
            "telephone_number": "661-322-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMINO",
        "first_name": "RENA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.S, PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF59257",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENA",
            "last_name": "VASQUEZ",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.