Individual
JOHN R. GILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 EMELINE AVE, 2ND FLOOR, SANTA CRUZ, CA 95060-1976
(831) 454-4170
(831) 454-4663
Mailing address
1400 EMELINE AVE, 2ND FLOOR, SANTA CRUZ, CA 95060-1976
(831) 454-4170
(831) 454-4663
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C29328
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C293280
—
CA
01
—
C29328
PROFESSIONAL LICENSE #
CA
01
—
ZZZ91891Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
01
—
ZZZ91892Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
01
—
ZZZ92069Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
Enumeration date
10/31/2005
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us