Healthcare Provider Details

I. General information

NPI: 1922815687
Provider Name (Legal Business Name): GERIN GASKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 08/29/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4063 BIRCH ST STE 220
NEWPORT BEACH CA
92660-2241
US

IV. Provider business mailing address

162 MAR VISTA DR
VISTA CA
92083-7640
US

V. Phone/Fax

Practice location:
  • Phone: 949-229-5708
  • Fax:
Mailing address:
  • Phone: 858-504-8443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY36032
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-16-24609
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: