Healthcare Provider Details

I. General information

NPI: 1689278517
Provider Name (Legal Business Name): VANESSA ROSE GARCIA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2020
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 REGENT ST STE 524
BERKELEY CA
94705-2120
US

IV. Provider business mailing address

829 LEXINGTON AVE
EL CERRITO CA
94530-2824
US

V. Phone/Fax

Practice location:
  • Phone: 510-495-0310
  • Fax: 510-244-0446
Mailing address:
  • Phone: 510-759-3194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236135
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95015550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: