MEDICARE: CARLA PATRICIA GARCIA LCSW, PPSC

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	1041S0200X	School Social Worker	160075626	CA
2	1041C0700X	Clinical Social Worker	LCSW88713	CA

General Provider Information

NPI Number	:	1245599570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA PATRICIA GARCIA LCSW, PPSC

Provider Business Mailing Address
First Line	:	1300 BAKER ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93305-4326
Country	:	US
Telephone Number	:	661-631-5895
Fax Number	:	661-631-5898

Provider Business Practice Location Address
First Line	:	2951 CENTER ST
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93306-5303
Country	:	US
Telephone Number	:	661-631-3206
Fax Number	:	661-321-0011

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

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	06/25/2020

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