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General NPI Number Information
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NPI Number | 1801747910
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Entity Type | Organization
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Legal Business Name | MARYSA V. GARCIA LICENSED CLINICAL SOCIAL WORKER APC
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1440 N HARBOR BLVD # 839A
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City | FULLERTON
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State | CA
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Zip | 92835-4127
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Country | US
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Telephone | 714-202-6071
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 411
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City | ORANGE
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State | CA
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Zip | 92856-6411
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Country | US
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Telephone | 714-202-6071
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARYSA VICTORIA GARCIA
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Credential | LCSW
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Telephone | 714-202-6071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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