Healthcare Provider Details

I. General information

NPI: 1477953255
Provider Name (Legal Business Name): SALVADOR J GARCIA LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 DUET
IRVINE CA
92603-4216
US

IV. Provider business mailing address

42 DUET
IRVINE CA
92603-4216
US

V. Phone/Fax

Practice location:
  • Phone: 714-227-0678
  • Fax:
Mailing address:
  • Phone: 714-227-0678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number8306
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: