Healthcare Provider Details

I. General information

NPI: 1487298261
Provider Name (Legal Business Name): NATALIA GARCIA LICENSED CLINICAL SOCIAL WORKER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 N CITRUS AVE STE D
COVINA CA
91723-2039
US

IV. Provider business mailing address

1004 W WEST COVINA PKWY # 109
WEST COVINA CA
91790-2810
US

V. Phone/Fax

Practice location:
  • Phone: 661-809-4385
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATALIA VENTURA GARCIA
Title or Position: CEO/PRESIDENT
Credential:
Phone: 661-809-4385