MEDICARE: MRS. MONTANA COLLEEN KNAPP GARCIA LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	144496	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	144496	OTHER	CA	BOARD OF BEHAVIORAL SCIENCES

General Provider Information

NPI Number	:	1063910610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONTANA COLLEEN KNAPP GARCIA LMFT

Provider Business Mailing Address
First Line	:	225 AVENUE E
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5088
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 AVENUE E
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5088
Country	:	US
Telephone Number	:	818-574-9887
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2018
Last Update Date	:	01/29/2024

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