Healthcare Provider Details

I. General information

NPI: 1649078320
Provider Name (Legal Business Name): GJB HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N GILBERT RD BSMT 5
GILBERT AZ
85234-5801
US

IV. Provider business mailing address

2607 N JAY ST
CHANDLER AZ
85225-2169
US

V. Phone/Fax

Practice location:
  • Phone: 480-847-1980
  • Fax: 480-906-1580
Mailing address:
  • Phone: 480-847-1980
  • Fax: 480-906-1580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GEORGE BERNT
Title or Position: PROVIDER PRACTICE OWNER
Credential: FNP-C, PMHNP-BC
Phone: 480-258-1828