Provider Demographics
NPI:1316304785
Name:GARD'NER, ALETHEA (LCSW)
Entity type:Individual
Prefix:
First Name:ALETHEA
Middle Name:
Last Name:GARD'NER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 OLYMPIC BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5097
Mailing Address - Country:US
Mailing Address - Phone:925-588-3948
Mailing Address - Fax:
Practice Address - Street 1:1910 OLYMPIC BLVD STE 260
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5097
Practice Address - Country:US
Practice Address - Phone:925-588-3948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW292151041C0700X
GACSW0033011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical