Healthcare Provider Details

I. General information

NPI: 1689447252
Provider Name (Legal Business Name): LUCIA GARCIA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 SANTA FE AVE APT J
LONG BEACH CA
90810-3582
US

IV. Provider business mailing address

2240 SANTA FE AVE APT J
LONG BEACH CA
90810-3582
US

V. Phone/Fax

Practice location:
  • Phone: 323-540-1170
  • Fax:
Mailing address:
  • Phone: 323-540-1170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW112966
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: