MEDICARE: DR. CARA A GARDENSWARTZ PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PSY18399	CA

General Provider Information

NPI Number	:	1346345964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARA A GARDENSWARTZ PHD

Provider Business Mailing Address
First Line	:	227 S WOODBURN DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-3028
Country	:	US
Telephone Number	:	310-893-0096
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 DOWNING ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-4704
Country	:	US
Telephone Number	:	310-893-0096
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	11/13/2023

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