=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124169917
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATIA G GARCIA PMHNP-BC, MSN, BSN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2007
-----------------------------------------------------
Last Update Date | 07/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 S SAN PEDRO ST STE 302
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90012-5308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-643-7980
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 777 S ALAMEDA ST FL 2
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90021-1656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-643-7980
-----------------------------------------------------
Fax | 323-297-1513
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | NP95030258
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------