MEDICARE: LORIE A. GEARHART MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A97994	CA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084F0202X	Forensic Psychiatry Physician	A97994	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	ZZZ91891Z	OTHER	CA	SANTA CRUZ COUNTY MEDICARE GROUP
4	ZZZ92069Z	OTHER	CA	SANTA CRUZ COUNTY MEDICARE GROUP
5	ZZZ91892Z	OTHER	CA	SANTA CRUZ COUNTY MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619006954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORIE A. GEARHART MD

Provider Business Mailing Address
First Line	:	820 BAY AVE STE 206
Second Line	:
City	:	CAPITOLA
State	:	CA
Zip	:	95010-2102
Country	:	US
Telephone Number	:	831-246-6392
Fax Number	:	831-600-7528

Provider Business Practice Location Address
First Line	:	820 BAY AVE STE 206
Second Line	:
City	:	CAPITOLA
State	:	CA
Zip	:	95010-2102
Country	:	US
Telephone Number	:	831-427-3100
Fax Number	:	831-515-7037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2007
Last Update Date	:	05/15/2026

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Directions to “ LORIE A. GEARHART MD” Practice Location

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