Individual
LAKEYLA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
837 ADDISON ST, BERKELEY, CA 94710-2047
(510) 981-4100
Mailing address
PO BOX 11247, BERKELEY, CA 94712-2247
(510) 981-4100
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95017057
CA
Other
Enumeration date
10/14/2018
Last updated
10/12/2022
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