Healthcare Provider Details

I. General information

NPI: 1891213484
Provider Name (Legal Business Name): GARCIA FCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 GAYLENE DR
SANTA MARIA CA
93458-1221
US

IV. Provider business mailing address

1036 GAYLENE DR
SANTA MARIA CA
93458-1221
US

V. Phone/Fax

Practice location:
  • Phone: 805-922-9300
  • Fax:
Mailing address:
  • Phone: 805-922-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID LAUREL SCOTT
Title or Position: CLINICAL SERVICES DIRECTOR
Credential: PSY.D., LMFT
Phone: 805-260-4676