MEDICARE: MRS. STEPHANIE GARCIA

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	124Q00000X	Dental Hygienist	30575	CA

General Provider Information

NPI Number	:	1376405217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE GARCIA

Provider Business Mailing Address
First Line	:	319 BASSWOOD CMN UNIT 12
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94551-6495
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 BASSWOOD CMN UNIT 12
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94551-6495
Country	:	US
Telephone Number	:	925-344-9644
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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