Healthcare Provider Details

I. General information

NPI: 1750215141
Provider Name (Legal Business Name): ALEXANDRIA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 BRENTWOOD DR
GRASS VALLEY CA
95945-5703
US

IV. Provider business mailing address

406 SUNRISE AVE STE 105
ROSEVILLE CA
95661-4145
US

V. Phone/Fax

Practice location:
  • Phone: 916-782-3737
  • Fax:
Mailing address:
  • Phone: 916-782-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRT1446600626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: