Healthcare Provider Details

I. General information

NPI: 1598378408
Provider Name (Legal Business Name): AMELIA ANN GARCIA APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMELIA ANN VALOIS/GALLEGOS

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E MORRIS AVE
MODESTO CA
95354-0437
US

IV. Provider business mailing address

421 E MORRIS AVE
MODESTO CA
95354-0437
US

V. Phone/Fax

Practice location:
  • Phone: 209-525-5080
  • Fax:
Mailing address:
  • Phone: 209-525-5080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC6527
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number19780
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: