Alexandra Tara Gardner

Individual provider Active NPI Peer Specialist · Grass Valley, CA

NPI 1003694050 · NPPES record last updated Sep 20, 2023

Key facts

NPI
1003694050
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
16573 Old Auburn Rd
Grass Valley, CA 95949
Phone
(530) 273-0631
Fax
(916) 504-4328
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Respite Center Current
since Sep 24, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

16573 Old Auburn Rd
Grass Valley, CA 95949

Mailing address

16573 Old Auburn Rd
Grass Valley, CA 95949
Phone (530) 273-0631

Other providers in Grass Valley, CA

All providers in Grass Valley, CA · Peer Specialist in California

Sources for this page

Verify at the official NPI Registry.