Robert W. Gardner PSG-Dr. Gardner Outpatient Program

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

170007AP Issued in CA

Legal business name

ROBERT W. GARDNER PSG-DR. GARDNER OUTPATIENT PROGRAM

Practice address

6300 E. Hwy 20
Lucerne, CA 95458

Phone

(707) 274-9299

Fax

(707) 274-9297

NPI assigned

Nov 16, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Robert William Gardner, M.D.

Title

Medical Director

Phone

(707) 274-9299

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258329600000",
    "number": "1023345857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1978",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "95458",
            "telephone_number": "707-274-9299",
            "fax_number": "707-274-9297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 E. HWY 20",
            "city": "LUCERNE",
            "state": "CA",
            "postal_code": "95458",
            "telephone_number": "707-274-9299",
            "fax_number": "707-274-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W. GARDNER PSG-DR. GARDNER OUTPATIENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "707-274-9299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "170007AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Thomas Pearson
• Tiffany Pimentel, SUDRC
• PSG-Dr. Gardner Outpatient Program
• Douglas Houston Reams, DDS
• Robert W. Gardner Dr. Gardner Outpatient Program
• Joanne Margaret Rode, PA
• Sheila Elaine Roseneau
• Robyn Carrie Rosin, RAS
• Anthony Michael Sage
• Steven J Schepper, M.D.

• Community/Behavioral Health Agency in Lucerne, CA
• Providers in Lucerne, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.