Provider Demographics
NPI:1881677342
Name:GARDINER, BARBARA L (MFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:GARDINER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12842 VALLEY VIEW ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2515
Mailing Address - Country:US
Mailing Address - Phone:714-897-1505
Mailing Address - Fax:714-379-5434
Practice Address - Street 1:12842 VALLEY VIEW ST
Practice Address - Street 2:SUITE 106
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2515
Practice Address - Country:US
Practice Address - Phone:714-897-1505
Practice Address - Fax:714-379-5434
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30826106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist