Provider Demographics
NPI:1275699704
Name:GERIHEALTHSOLUTIONS, INC.
Entity Type:Organization
Organization Name:GERIHEALTHSOLUTIONS, INC.
Other - Org Name:GERIHEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAKERJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-899-9800
Mailing Address - Street 1:750 GRANT AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-7001
Mailing Address - Country:US
Mailing Address - Phone:415-899-9800
Mailing Address - Fax:415-899-9805
Practice Address - Street 1:750 GRANT AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-7001
Practice Address - Country:US
Practice Address - Phone:415-899-9800
Practice Address - Fax:415-899-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4924363LG0600X
CA8749363LG0600X
CA8750363LG0600X
CA294363LG0600X
CA11529363LG0600X
CA10022363LG0600X
CA10811363LG0600X
CA13815364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGNP000180Medicaid
CAGNP000180Medicaid
CAZZZ04895ZMedicare PIN