NPIMap

Organization Active NPI

PSG-Dr. Gardner Outpatient Program

  • Community/Behavioral Health Agency
  • Lucerne, CA
National Provider Identifier
1457569949
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PSG-DR. GARDNER OUTPATIENT PROGRAM
Practice address
6300 E. Hwy 20
Lucerne, CA 95458
Phone
(707) 274-9299
Fax
(707) 274-9297
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kay Lanier
Title
Program Director
Phone
(707) 274-9299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

6300 E. Hwy 20
Lucerne, CA 95458

Mailing address

P.O. Box 1978
Lucerne, CA 95458
Phone (707) 274-9299

National Provider Directory

National Provider Directory
Tax ID family
Dr Gardner Outpatient Program4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457569949",
    "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": "PSG-DR. GARDNER OUTPATIENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LANIER",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "707-274-9299"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucerne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.