Healthcare Provider Details

I. General information

NPI: 1801772272
Provider Name (Legal Business Name): ANNETTE GARCIA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20700 THUNDERBIRD RD
APPLE VALLEY CA
92307-3322
US

IV. Provider business mailing address

12555 NAVAJO RD
APPLE VALLEY CA
92308-7256
US

V. Phone/Fax

Practice location:
  • Phone: 760-242-7011
  • Fax:
Mailing address:
  • Phone: 760-247-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: