person
Mr. Lee Ray Gardner JR.
Addiction (Substance Use Disorder) Counselor in San Jose, California
NPI 1871635235

Lee Ray Gardner JR. is an Addiction (Substance Use Disorder) Counselor based in San Jose, CA and is specialized in Addiction (Substance Use Disorder). Lee Ray Gardner JR. practices in San Jose, CA. The NPI Number for Lee Ray Gardner JR. is 1871635235 and holds a License No. (California).

The current practice location address for Lee Ray Gardner JR. is 160 E Virginia St Ste 100, San Jose, CA and can be reached out via phone at 408-938-2113 and via fax at 408-977-1136. You can also correspond with Lee Ray Gardner JR. through the mailing address at 160 E VIRGINIA ST STE 100, SAN JOSE, CA - 95112-5865 (mailing address contact number: 408-457-7100).

Location: 160 E Virginia St Ste 100, San Jose, CA, 95112-5865
person
Provider Profile Details
NPI Number
1871635235
Provider Name
Lee Ray Gardner JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
160 E Virginia St Ste 100, San Jose, CA, 95112-5865
Phone Number
408-938-2113
Fax Number
408-977-1136
Provider Enumeration Date
02/13/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
160 E Virginia St Ste 100
City
State
Zip
95112-5865
Phone Number
408-938-2113
Fax Number
408-977-1136
person
Provider Business Mailing Address Details
Address
160 E Virginia St Ste 100
City
State
Zip
95112-5865
Phone Number
408-938-2113
Fax Number
408-977-1136
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
R1463650322 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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