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General NPI Number Information
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NPI Number | 1609727049
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Entity Type | Individual
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Provider Name | RONALD E GARDNER
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Gender | Male
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 9909 HUENNEKENS ST STE 110
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City | SAN DIEGO
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State | CA
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Zip | 92121-2928
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Country | US
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Telephone | 858-500-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 301 W VERMONT AVE APT 817
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City | ESCONDIDO
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State | CA
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Zip | 92025-6572
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Country | US
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Telephone | 760-877-6494
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CI48800925
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License Number State | CA
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