MEDICARE: JESSICA MICHELE GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW124099	CA

General Provider Information

NPI Number	:	1568010585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MICHELE GARCIA

Provider Business Mailing Address
First Line	:	1496 KENMORE RD
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-4532
Country	:	US
Telephone Number	:	626-827-1672
Fax Number	:

Provider Business Practice Location Address
First Line	:	6041 BRISTOL PKWY STE 100
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6601
Country	:	US
Telephone Number	:	310-347-9676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2019
Last Update Date	:	04/01/2025

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