Provider Demographics
NPI:1326562083
Name:GARDE, MARIA SALOME (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SALOME
Last Name:GARDE
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 1:8834 MESA OAK DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-3179
Mailing Address - Country:US
Mailing Address - Phone:951-454-2505
Mailing Address - Fax:
Practice Address - Street 1:10917 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3044
Practice Address - Country:US
Practice Address - Phone:951-358-2600
Practice Address - Fax:951-454-2505
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW775941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical