Active NPI
Rita Frandsen Gardner, LCSW
- Clinical Psychologist
- Sacramento, CA
National Provider Identifier
1689871584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 24795
- Practice address
- 9130 Firelight Way
Sacramento, CA 95826-4125 - Phone
- (916) 361-1602
- NPI assigned
- Jul 2, 2007
- Last updated
- Mar 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 24795 | CA | Primary |
| Clinical Social Worker | 1041C0700X | 17730 LCSW | CA |
Addresses
Primary practice location
9130 Firelight Way
Sacramento, CA 95826-4125
Mailing address
9130 Firelight Way
Sacramento, CA 95826-4125
Phone (916) 361-1602
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17730 LCSW | Other | CA | BBS PROVIDER LICENSE # |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17730 LCSW | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426636800000",
"number": "1689871584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9130 FIRELIGHT WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958264125",
"telephone_number": "916-361-1602",
"fax_number": "916-361-1662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9130 FIRELIGHT WAY",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958264125",
"telephone_number": "916-361-1602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "RITA",
"middle_name": "FRANDSEN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-02",
"last_updated": "2015-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "24795",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "17730 LCSW",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BBS PROVIDER LICENSE #",
"identifier": "17730 LCSW",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.