Individual
ERIC J. GARDNER
Active
Individual
ERIC J. GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY. D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY24300
CA
103TC0700X
Clinical Psychologist
Primary
24300
CA
390200000X
Student in an Organized Health Care Education/Training Program
PSB33057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSB33057
PSYCH. ASSISTANT NUMBER
CA
Enumeration date
09/19/2007
Last updated
08/09/2019
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