Healthcare Provider Details

I. General information

NPI: 1700934387
Provider Name (Legal Business Name): MRS. JULIE M GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 E AMERICAN AVE
FRESNO CA
93725-9235
US

IV. Provider business mailing address

3333 E AMERICAN AVE
FRESNO CA
93725-9235
US

V. Phone/Fax

Practice location:
  • Phone: 559-495-3741
  • Fax:
Mailing address:
  • Phone: 559-495-3741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number71201
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: