Healthcare Provider Details

I. General information

NPI: 1932451853
Provider Name (Legal Business Name): CARRIE GERDIK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40700 CALIFORNIA OAKS RD STE 208
MURRIETA CA
92562-5789
US

IV. Provider business mailing address

40700 CALIFORNIA OAKS RD STE 208
MURRIETA CA
92562-5789
US

V. Phone/Fax

Practice location:
  • Phone: 888-858-2002
  • Fax: 951-257-7914
Mailing address:
  • Phone: 888-858-2002
  • Fax: 951-257-7914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number604605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: