Healthcare Provider Details

I. General information

NPI: 1710484209
Provider Name (Legal Business Name): JORGE EDUARDO GARCIA BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 CARNEGIE DR
SAN BERNARDINO CA
92408-3500
US

IV. Provider business mailing address

21600 OXNARD ST STE 1800
WOODLAND HILLS CA
91367-7807
US

V. Phone/Fax

Practice location:
  • Phone: 909-756-8887
  • Fax:
Mailing address:
  • Phone: 818-345-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberF2475914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: