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NPI Code Detail

MEDICARE: KELISHA RAM GARDEEN

MEDICARE: KELISHA RAM GARDEEN
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
1103TC0700XClinical Psychologist36551CA

General Provider Information

NPI Number : 1922959931
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELISHA RAM GARDEEN
Provider Business Mailing Address
First Line : 550 FELL ST APT 14
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5033
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1749 MARTIN LUTHER KING JR WAY
Second Line :
City : BERKELEY
State : CA
Zip : 94709-2139
Country : US
Telephone Number : 498-952-8730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ KELISHA RAM GARDEEN ” Practice Location

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