MEDICARE: ANGELA SANDOVAL GARCIA LMFT

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	77840	CA

General Provider Information

NPI Number	:	1912322546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA SANDOVAL GARCIA LMFT

Provider Business Mailing Address
First Line	:	501 N BROOKHURST ST STE 320
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-5204
Country	:	US
Telephone Number	:	714-490-7711
Fax Number	:	714-490-7717

Provider Business Practice Location Address
First Line	:	4110 EDISON AVE STE 206A
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-8417
Country	:	US
Telephone Number	:	951-454-5577
Fax Number	:

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

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	01/02/2025

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