Healthcare Provider Details

I. General information

NPI: 1619006954
Provider Name (Legal Business Name): LORIE A. GEARHART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 BAY AVE STE 206
CAPITOLA CA
95010-2102
US

IV. Provider business mailing address

820 BAY AVE STE 206
CAPITOLA CA
95010-2102
US

V. Phone/Fax

Practice location:
  • Phone: 831-427-3100
  • Fax: 831-515-7037
Mailing address:
  • Phone: 831-246-6392
  • Fax: 831-600-7528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA97994
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberA97994
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: