Healthcare Provider Details

I. General information

NPI: 1467677104
Provider Name (Legal Business Name): KRISTINE L GARCIA LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3234 MARYSVILLE BLVD
SACRAMENTO CA
95815-1411
US

IV. Provider business mailing address

3234 MARYSVILLE BLVD
SACRAMENTO CA
95815-1411
US

V. Phone/Fax

Practice location:
  • Phone: 916-706-7480
  • Fax:
Mailing address:
  • Phone: 916-706-7480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM0130
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: