Healthcare Provider Details

I. General information

NPI: 1265751499
Provider Name (Legal Business Name): LUISA CLEMENCIA GARCIA APRN, FNP-C PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2261 MARKET ST STE 10222
SAN FRANCISCO CA
94114-1612
US

IV. Provider business mailing address

11900 MCGREGOR BLVD
FORT MYERS FL
33919-2545
US

V. Phone/Fax

Practice location:
  • Phone: 239-790-8822
  • Fax: 561-257-3956
Mailing address:
  • Phone: 239-790-8822
  • Fax: 561-257-3956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9233621
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0101103-C-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-RXN.0100748-C-NP
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number297661
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9233621
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: