Healthcare Provider Details

I. General information

NPI: 1477119642
Provider Name (Legal Business Name): TANGELIA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 EXECUTIVE PARK BLVD
SAN FRANCISCO CA
94134-3394
US

IV. Provider business mailing address

250 EXECUTIVE PARK BLVD STE 4900
SAN FRANCISCO CA
94134-3335
US

V. Phone/Fax

Practice location:
  • Phone: 707-576-7700
  • Fax: 707-757-2929
Mailing address:
  • Phone: 707-576-7700
  • Fax: 707-757-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW132147
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW132147
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW132147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: