Healthcare Provider Details

I. General information

NPI: 1760110829
Provider Name (Legal Business Name): EDUARDO GARCIA JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 MEADOW AVE
STOCKTON CA
95207-1331
US

IV. Provider business mailing address

2450 MEADOW AVE
STOCKTON CA
95207-1331
US

V. Phone/Fax

Practice location:
  • Phone: 209-953-8768
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: