Active NPI
Offra Gielan Gerstein, PH.D.
- Psychologist
- Santa Cruz, CA
National Provider Identifier
1740510643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY4707
- Practice address
- 3333 Mission Dr
Santa Cruz, CA 95065-1827 - Phone
- (831) 476-7666
- Fax
- (831) 479-7005
- NPI assigned
- Dec 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY4707 | CA | Primary |
Addresses
Primary practice location
3333 Mission Dr
Santa Cruz, CA 95065-1827
Mailing address
3333 Mission Dr
Santa Cruz, CA 95065-1827
Phone (831) 476-7666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY4707 | Other | CA | BOARD OF PSYCHOLOGY |
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
- Opted out of Medicare
- Yes, effective Jul 1, 2016 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY4707 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261958400000",
"number": "1740510643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 MISSION DR",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651827",
"telephone_number": "831-476-7666",
"fax_number": "831-479-7005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 MISSION DR",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651827",
"telephone_number": "831-476-7666",
"fax_number": "831-479-7005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERSTEIN",
"first_name": "OFFRA",
"middle_name": "GIELAN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-28",
"last_updated": "2009-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY4707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PSYCHOLOGY",
"identifier": "PSY4707",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.