Healthcare Provider Details

I. General information

NPI: 1427177682
Provider Name (Legal Business Name): STARLIGHT MELODY GARCIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 S VERMONT AVE FL 4
LOS ANGELES CA
90044-3493
US

IV. Provider business mailing address

13627 KALNOR AVE
NORWALK CA
90650-4023
US

V. Phone/Fax

Practice location:
  • Phone: 213-924-0616
  • Fax:
Mailing address:
  • Phone: 323-304-8726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: