Provider Demographics
NPI:1548527633
Name:DARDEN, GABRIEL CHRISTOPHER
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:CHRISTOPHER
Last Name:DARDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:GABRIEL
Other - Middle Name:CHRISTOPHER
Other - Last Name:DARDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:423 DUANE ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-1010
Mailing Address - Country:US
Mailing Address - Phone:650-796-8164
Mailing Address - Fax:
Practice Address - Street 1:423 DUANE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1010
Practice Address - Country:US
Practice Address - Phone:650-796-8164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT6595225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant