Healthcare Provider Details

I. General information

NPI: 1275309536
Provider Name (Legal Business Name): AIYANA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12655 ALTA MESA RD
HERALD CA
95638-8414
US

IV. Provider business mailing address

12655 ALTA MESA RD
HERALD CA
95638-8414
US

V. Phone/Fax

Practice location:
  • Phone: 916-704-2199
  • Fax:
Mailing address:
  • Phone: 916-704-2199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: