Healthcare Provider Details

I. General information

NPI: 1013585827
Provider Name (Legal Business Name): LINDA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2021
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 WILLOW AVE STE 102
CLOVIS CA
93612-4750
US

IV. Provider business mailing address

2426 N ADOLINE AVE
FRESNO CA
93705-4602
US

V. Phone/Fax

Practice location:
  • Phone: 559-428-3012
  • Fax: 559-475-8052
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: