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NPI Code Detail

MEDICARE: RONALD JAMES GARDNER

MEDICARE:   RONALD JAMES GARDNER
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
11041C0700XClinical Social Worker5004CA

General Provider Information

NPI Number : 1518778174
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD JAMES GARDNER
Provider Business Mailing Address
First Line : 9433 ALDER ST
Second Line : 9433 ALDER STREET
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-9173
Country : US
Telephone Number : 909-322-0588
Fax Number :
Provider Business Practice Location Address
First Line : 9433 ALDER ST
Second Line : 9433 ALDER STREET
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-9173
Country : US
Telephone Number : 909-322-0588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2025
Last Update Date : 01/14/2025

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Directions to “ RONALD JAMES GARDNER ” Practice Location

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