Healthcare Provider Details

I. General information

NPI: 1336893338
Provider Name (Legal Business Name): KEYLA MELISSA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W CYPRESS AVE
VISALIA CA
93277-8300
US

IV. Provider business mailing address

5000 W CYPRESS AVE
VISALIA CA
93277-8300
US

V. Phone/Fax

Practice location:
  • Phone: 559-730-7300
  • Fax:
Mailing address:
  • Phone: 559-730-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number109509
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number109509
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number109509
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number142037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: