Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 77940 | CA |
N | 104100000X | Social Worker | ||
N | 1041S0200X | School Social Worker | CA | |
N | 225400000X | Rehabilitation Practitioner | CA |
NPI | 1043614969 |
---|---|
Provider Name | Jacqueline Garcia |
First Address | Riverside, CA 92506-3907 |
Second Address | Riverside, CA 92506-3907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2014 |
Last Update Date | 26/06/2019 |