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NPI 1760133276

NPI 1760133276 : JESUS GARCIA : BAKERSFIELD, CA

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General NPI Number Information
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    NPI Number           |    1760133276
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    Entity Type          |    Individual 
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    Provider Name        |    JESUS GARCIA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/17/2022
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    Last Update Date     |    01/17/2022
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Provider Practice Location Address
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    Address Line         |    2901 S H ST 
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    City                 |    BAKERSFIELD
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    State                |    CA
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    Zip                  |    93304-5602
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    Country              |    US
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    Telephone            |    661-398-4303
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    Fax                  |    661-326-1455
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Provider Business Mailing Address
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    Address Line         |    2901 S H ST 
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    City                 |    BAKERSFIELD
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    State                |    CA
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    Zip                  |    93304-5602
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    Country              |    US
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    Telephone            |    661-398-4303
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    Fax                  |    661-326-1455
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    12459
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    License Number State |    CA
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