Healthcare Provider Details

I. General information

NPI: 1891604286
Provider Name (Legal Business Name): SELENA MONIQUE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 E BETTERAVIA RD STE 201
SANTA MARIA CA
93454-7023
US

IV. Provider business mailing address

1285 W RIVERGLEN AVE
REEDLEY CA
93654-2762
US

V. Phone/Fax

Practice location:
  • Phone: 805-621-7714
  • Fax:
Mailing address:
  • Phone: 559-643-9715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: