Healthcare Provider Details

I. General information

NPI: 1891609368
Provider Name (Legal Business Name): GERARDO GARCIA GASCA BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GERARDO GARCIA BCBA

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 E SOUTHERN AVE STE 210
MESA AZ
85204-5043
US

IV. Provider business mailing address

931 E SOUTHERN AVE STE 210
MESA AZ
85204-5043
US

V. Phone/Fax

Practice location:
  • Phone: 877-264-6747
  • Fax:
Mailing address:
  • Phone: 877-264-6747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: