Healthcare Provider Details

I. General information

NPI: 1669744272
Provider Name (Legal Business Name): JANICE GARCIA BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3244 E GREEN ST
PASADENA CA
91107-3836
US

IV. Provider business mailing address

PO BOX 1039
ROSEMEAD CA
91770-1000
US

V. Phone/Fax

Practice location:
  • Phone: 626-844-3033
  • Fax:
Mailing address:
  • Phone: 626-280-6510
  • Fax: 626-288-1026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number36303
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number36303
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number93731
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: