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Contact Information

ERIC J GARDNER, PSY. D.
516 EAST NIZHONI BLVD.
GALLUP, NM87301-1337
 Phone: 505-722-1000
 Fax: 505-722-1396
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Psychologist

103T00000X 62 Psychologist, Clinical
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ERIC J GARDNER · (Male)

NPI # 1861688269
Status Active
Credentials PSY. D.
Entity Individual
Enumeration date 09/19/2007
Last updated 08/09/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 24300
  • CA License # PSB33057
  • CA License # PSY24300
  • CA Other PSB33057 PSYCH. ASSISTANT NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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