=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750163754
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MONTSERRAT GARCIA NBC-HWC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2023
-----------------------------------------------------
Last Update Date | 10/16/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 909 RICHLAND RD SPC 135
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92069-9636
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-786-1804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 909 RICHLAND RD SPC 135
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92069-9636
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-786-1804
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171400000X
-----------------------------------------------------
Taxonomy Name | Health & Wellness Coach
-----------------------------------------------------
License Number | A-3252813
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------