Healthcare Provider Details

I. General information

NPI: 1407603020
Provider Name (Legal Business Name): VICKIE GARCIA DE ALBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 LAUREL ST
SAN CARLOS CA
94070-3918
US

IV. Provider business mailing address

1033 LAUREL ST
SAN CARLOS CA
94070-3918
US

V. Phone/Fax

Practice location:
  • Phone: 650-394-5155
  • Fax:
Mailing address:
  • Phone: 650-394-5155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC22339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: