Eunice Grace Gardner, PH.D.

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

Practice address

777 Hospital Way
Pocatello, ID 83201-5175

Phone

(208) 239-1710

NPI assigned

Jul 5, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Eunice Sullivan Gardner Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

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    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1003128265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "EUNICE",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-05",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUNICE",
            "last_name": "GARDNER",
            "middle_name": "SULLIVAN",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Esmeralda Garcia, LPC
• Jolyn Garcia
• Maria Guadalupe Garcia
• Rachel Mae Garcia, LPC, NCC
• Erinn Leigh Gardiner
• Kayce N Gardner, PA-C
• Valerie Yancey Gardner, PHARMD
• Adam Garfield, P.A.
• Terraka Garner, LMSW
• Brittany Garrett, DPT

• Adult Development & Aging Psychologist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Adult Development & Aging Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.