Active NPI
Rachel Maria Gardner, PSY.D.
- Psychologist
- Santa Rosa, CA
National Provider Identifier
1235634056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 825 College Ave
# 5
Santa Rosa, CA 95404-4108 - Phone
- (707) 806-8731
- NPI assigned
- Mar 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | |||
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
825 College Ave
# 5
Santa Rosa, CA 95404-4108
Mailing address
PO Box 2944
Santa Rosa, CA 95405-0944
Phone (707) 806-8731
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642982400000",
"number": "1235634056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2944",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954050944",
"telephone_number": "707-806-8731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 COLLEGE AVE",
"address_2": "# 5",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954044108",
"telephone_number": "707-806-8731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "RACHEL",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-25",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.