Healthcare Provider Details

I. General information

NPI: 1982129870
Provider Name (Legal Business Name): PAMELA GARCIA LCSW100507
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W METROPOLITAN DR STE 400
ORANGE CA
92868-3503
US

IV. Provider business mailing address

4000 W METROPOLITAN DR STE 400
ORANGE CA
92868-3503
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-5337
  • Fax:
Mailing address:
  • Phone: 714-834-5337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW100507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: