Healthcare Provider Details
I. General information
NPI: 1639356165
Provider Name (Legal Business Name): CHARLES A. GARCIA M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/28/2008
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3555 AUBURN BLVD., SACRAMENTO, CA 95821
SACRAMENTO CA
95821
US
IV. Provider business mailing address
850 E GARLAND AVE
FRESNO CA
93704-4847
US
V. Phone/Fax
- Phone: 916-482-2370
- Fax:
- Phone: 559-802-2992
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MFT INTERN 59214 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 89896 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: