Healthcare Provider Details

I. General information

NPI: 1417878844
Provider Name (Legal Business Name): ANNA GJERTSEN PSYD., BCB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

987 OLD EAGLE SCHOOL RD STE 719
WAYNE PA
19087-1708
US

IV. Provider business mailing address

3131 MEETINGHOUSE RD APT V15
UPPER CHICHESTER PA
19061-2988
US

V. Phone/Fax

Practice location:
  • Phone: 610-971-2277
  • Fax:
Mailing address:
  • Phone: 609-947-7324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: