Healthcare Provider Details

I. General information

NPI: 1639090806
Provider Name (Legal Business Name): JESSIKA SUE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 ARAMINGO AVE STE 11
PHILADELPHIA PA
19134-4531
US

IV. Provider business mailing address

4144 BENNINGTON ST
PHILADELPHIA PA
19124-5217
US

V. Phone/Fax

Practice location:
  • Phone: 215-203-1930
  • Fax:
Mailing address:
  • Phone: 267-318-5269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI005921
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: