Healthcare Provider Details
I. General information
NPI: 1811026032
Provider Name (Legal Business Name): LOUISA MARIA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2351 CARDINAL LN #B
SAN DIEGO CA
92123-3743
US
IV. Provider business mailing address
2351 CARDINAL LN #B
SAN DIEGO CA
92123-3743
US
V. Phone/Fax
- Phone: 858-573-2227
- Fax:
- Phone: 858-573-2227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: