Healthcare Provider Details

I. General information

NPI: 1760141824
Provider Name (Legal Business Name): ALEJANDRO GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3793 N POLK AVE
FRESNO CA
93722-9763
US

IV. Provider business mailing address

22493 AVENUE 11
MADERA CA
93637-9310
US

V. Phone/Fax

Practice location:
  • Phone: 559-271-1206
  • Fax:
Mailing address:
  • Phone: 559-718-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: