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NPI Code Detail

MEDICARE: VANESSA AVILA GARCIA

MEDICARE:   VANESSA  AVILA 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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1639026842
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA AVILA GARCIA
Provider Business Mailing Address
First Line : 1075 CREEKSIDE RIDGE DR STE 280
Second Line :
City : ROSEVILLE
State : CA
Zip : 95678-3504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1011 ROSEMARIE LN APT 53
Second Line :
City : STOCKTON
State : CA
Zip : 95207-6813
Country : US
Telephone Number : 360-244-3934
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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Directions to “ VANESSA AVILA GARCIA ” Practice Location

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