MEDICARE: MRS. DENISSE 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	58733	CA

General Provider Information

NPI Number	:	1457577033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENISSE GARCIA MA

Provider Business Mailing Address
First Line	:	237 DORE ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-4307
Country	:	US
Telephone Number	:	619-921-5217
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 EXECUTIVE PARK BLVD STE 4900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94134-3335
Country	:	US
Telephone Number	:	619-921-5217
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	09/30/2009

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