Healthcare Provider Details

I. General information

NPI: 1588576466
Provider Name (Legal Business Name): DAVINA MARTIKA GARCIA P.P.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 ROYAL OAKS DR
DUARTE CA
91010
US

IV. Provider business mailing address

5521 N TWINTREE AVE
AZUSA CA
91702-5855
US

V. Phone/Fax

Practice location:
  • Phone: 626-599-5408
  • Fax:
Mailing address:
  • Phone: 626-599-5408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberD8484417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: