Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1104243567 |
---|---|
Provider Name | Angelica Garcia |
First Address | Los Angeles, CA 90007-3033 |
Second Address | Los Angeles, CA 90007-4203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 27/03/2014 |