Healthcare Provider Details

I. General information

NPI: 1841984796
Provider Name (Legal Business Name): ADRIANNA GERBER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 CANYON CREST DR STE 209
RIVERSIDE CA
92507-6323
US

IV. Provider business mailing address

1192 MIRA VALLE ST
CORONA CA
92879-8559
US

V. Phone/Fax

Practice location:
  • Phone: 951-425-4105
  • Fax:
Mailing address:
  • Phone: 951-227-0480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS111556
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: