Healthcare Provider Details

I. General information

NPI: 1801517891
Provider Name (Legal Business Name): LYANNA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 W HILLCREST DR STE 106
THOUSAND OAKS CA
91360-7823
US

IV. Provider business mailing address

1951 NARANJA LN
OXNARD CA
93036-7957
US

V. Phone/Fax

Practice location:
  • Phone: 805-229-1034
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: