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General NPI Number Information
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NPI Number | 1851326342
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Entity Type | Individual
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Provider Name | JEAN LORETTA GALICA M.A.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17705 HALE AVE BLDG I, STE. 5
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City | MORGAN HILL
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State | CA
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Zip | 95037-4340
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Country | US
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Telephone | 408-644-3294
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Fax | 408-778-9917
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Provider Business Mailing Address
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Address Line | 658 MEADOW CREEK DR
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City | SAN JOSE
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State | CA
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Zip | 95136-1955
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC40309
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License Number State | CA
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