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Alexandra Tara Gardner
Peer Specialist in Grass Valley, California
NPI 1003694050

Alexandra Tara Gardner is a Peer Specialist based in Grass Valley, CA. Alexandra Tara Gardner practices in Grass Valley, CA. The NPI Number for Alexandra Tara Gardner is 1003694050 and holds a License No. (California).

The current practice location address for Alexandra Tara Gardner is 16573 Old Auburn Rd, Grass Valley, CA and can be reached out via phone at 530-273-0631 and via fax at 916-504-4328.

Location: 16573 Old Auburn Rd, Grass Valley, CA, 95949
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003694050
Provider Name
Alexandra Tara Gardner
Credential
Provider Entity Type
Individual
Gender
Female
Address
16573 Old Auburn Rd, Grass Valley, CA, 95949
Phone Number
530-273-0631
Fax Number
916-504-4328
Provider Enumeration Date
09/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
16573 Old Auburn Rd
City
Grass Valley
State
California
Zip
95949
Phone Number
530-273-0631
Fax Number
916-504-4328
person
Provider Business Mailing Address Details
Address
16573 Old Auburn Rd
City
Grass Valley
State
California
Zip
95949
Phone Number
530-273-0631
Fax Number
916-504-4328
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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