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General NPI Number Information
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NPI Number | 1437674819
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Entity Type | Individual
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Provider Name | INDIA O GARZA LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 720 WOOD ST
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City | EUREKA
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State | CA
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Zip | 95501-4413
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Country | US
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Telephone | 707-268-2990
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Fax |
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Provider Business Mailing Address
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Address Line | 2570 PINEVIEW DR
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City | FORTUNA
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State | CA
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Zip | 95540-3231
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Country | US
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Telephone | 707-798-7604
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 104589
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License Number State | CA
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