MEDICARE: KENNETH JULIAN 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	225400000X	Rehabilitation Practitioner
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1447461793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH JULIAN GARCIA

Provider Business Mailing Address
First Line	:	50 N HILL AVE STE 100
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1949
Country	:	US
Telephone Number	:	949-886-3392
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 N HILL AVE STE 100
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-1949
Country	:	US
Telephone Number	:	949-724-7137
Fax Number	:

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	12/03/2024

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Directions to “ KENNETH JULIAN GARCIA ” Practice Location

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