Ellen Marie Gardner

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

374438 Issued in CA

Practice address

3333 Chanate Rd
Santa Rosa, CA 95404-1707

Phone

(707) 565-4900

NPI assigned

Apr 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of Sonoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Rosa, CA
  • NPI 1306050828
  NPD (past)

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1114284122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "707-565-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "707-565-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "374438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Louise Garcia, LMFT
• Selena Alicia Garcia, DTR
• Vanessa Adine Garcia
• Valerie Sondra Garden, M.D.
• Dave Gardner
• Rachel Maria Gardner, PSY.D.
• Robert S. Gardner, M.D.
• Gardners Hearing Centers
• Garfield Beach CVS LLC
• Garfield Beach CVS LLC

• Registered Nurse in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.