Dr Gregory Gonzaga Desierto, PSYD is a
Psychologist based in Oakland, California. Dr Gregory Gonzaga Desierto is licensed to practice in California (license number PSY29598) and his current practice location is
3301 E 12th St Ste 259, Oakland, California. He can be reached at his office (for appointments etc.) via phone at
(510) 295-7402.
NPI number for Dr Gregory Gonzaga Desierto is 1164662581 and his current mailing address is 3301 E 12th St Ste 259, Oakland, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164662581.
Healthcare Provider's Profile
| Full Name | Dr Gregory Gonzaga Desierto |
|---|
| Gender | Male |
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| Speciality | Psychologist |
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| Location | 3301 E 12th St Ste 259, Oakland, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1164662581
- Provider Enumeration Date: 02/25/2009
- Last Update Date: 02/23/2018
Medical Identifiers
Medical identifiers for Dr Gregory Gonzaga Desierto such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164662581 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | PSY29598 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Gregory Gonzaga Desierto is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Gregory Gonzaga Desierto, PSYD
3301 E 12th St Ste 259,
Oakland, CA 94601-2940
Ph: (510) 295-7402 | Dr Gregory Gonzaga Desierto, PSYD
3301 E 12th St Ste 259,
Oakland, CA 94601-2940
Ph: (510) 295-7402 |
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