Healthcare Provider Details

I. General information

NPI: 1669949079
Provider Name (Legal Business Name): ISAI GARCIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR
OXNARD CA
93036-2612
US

IV. Provider business mailing address

17810 MERRIDY ST APT 106
NORTHRIDGE CA
91325-4688
US

V. Phone/Fax

Practice location:
  • Phone: 805-620-8087
  • Fax:
Mailing address:
  • Phone: 562-335-9187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberNONE
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: