Individual provider · Type 1 NPI

Gardner Carlson

Licensed Psychiatric Technician · Santa Rosa, CA

NPI number 1063977460 Active

Practice location

2225 Challenger Way
Santa Rosa, CA 95407-5441

Fax (707) 565-5183

Specialties and licenses

TaxonomyCodeLicense
Licensed Psychiatric Technician Primary 167G00000X31251 (CA)

Licensed Psychiatric Technician: An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental dis…

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About NPI 1063977460

Gardner Carlson's National Provider Identifier is 1063977460, issued on Feb 10, 2019. The primary taxonomy on file is Licensed Psychiatric Technician (167G00000X), and the practice location is in Santa Rosa, CA. The record was last updated on Feb 10, 2019.