Healthcare Provider Details

I. General information

NPI: 1366350076
Provider Name (Legal Business Name): JENNIFER MARIE GARCIA PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 E BADILLO ST
COVINA CA
91723-2803
US

IV. Provider business mailing address

3935 E KENYON PASEO
ONTARIO CA
91761-5266
US

V. Phone/Fax

Practice location:
  • Phone: 626-974-6020
  • Fax:
Mailing address:
  • Phone: 626-974-6037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number250099390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: