MEDICARE: MELISSA GARCIA MA

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	MFC 47821	CA

General Provider Information

NPI Number	:	1083780548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA GARCIA MA

Provider Business Mailing Address
First Line	:	3910 OAKWOOD AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-3413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7024 SEVILLE AVE
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4969
Country	:	US
Telephone Number	:	323-588-9600
Fax Number	:

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

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	03/19/2010

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