Individual
KIMBERLY GARDENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L, SWC
Contact information
Practice address
1932 14TH ST, SANTA MONICA, CA 90404-4605
(949) 683-0884
Mailing address
1932 14TH ST, SANTA MONICA, CA 90404-4605
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
12467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12467
CALIFORNIA BOARD OF OCCUPATIONAL THERAPY
CA
Enumeration date
10/20/2014
Last updated
04/21/2020
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