Healthcare Provider Details

I. General information

NPI: 1578300547
Provider Name (Legal Business Name): NOAH GARCIA LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 VAN NESS AVE
FRESNO CA
93721-1128
US

IV. Provider business mailing address

1649 VAN NESS AVE
FRESNO CA
93721-1128
US

V. Phone/Fax

Practice location:
  • Phone: 888-530-4415
  • Fax:
Mailing address:
  • Phone: 888-530-4415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: