Healthcare Provider Details

I. General information

NPI: 1689194680
Provider Name (Legal Business Name): CYNTHIA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1359 N. GRAND AVE.
COVINA CA
91724
US

IV. Provider business mailing address

1359 N GRAND AVE
COVINA CA
91724-1016
US

V. Phone/Fax

Practice location:
  • Phone: 626-430-2900
  • Fax: 626-331-0035
Mailing address:
  • Phone: 626-430-2900
  • Fax: 626-331-0035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: