MEDICARE: JESSICA JANE 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1811856727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA JANE GARCIA

Provider Business Mailing Address
First Line	:	870 E 9400 S STE 102
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84094-3694
Country	:	US
Telephone Number	:	385-238-8522
Fax Number	:	385-449-9331

Provider Business Practice Location Address
First Line	:	870 E 9400 S STE 102
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84094-3694
Country	:	US
Telephone Number	:	385-238-8522
Fax Number	:	385-449-9331

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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