MEDICARE: PRISCILLA GARCIA LCSW

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	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker	73839	CA

General Provider Information

NPI Number	:	1245533728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA GARCIA LCSW

Provider Business Mailing Address
First Line	:	9015 MURRAY AVE STE 100
Second Line	:
City	:	GILROY
State	:	CA
Zip	:	95020-3617
Country	:	US
Telephone Number	:	408-846-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	9015 MURRAY AVE STE 100
Second Line	:
City	:	GILROY
State	:	CA
Zip	:	95020-3617
Country	:	US
Telephone Number	:	408-846-7400
Fax Number	:

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

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	10/18/2016

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