Provider Demographics
NPI:1033591458
Name:GARCIA, MONICA ADELL (CI21580319)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ADELL
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CI21580319
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 EDELWEISS DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-3377
Mailing Address - Country:US
Mailing Address - Phone:562-464-8554
Mailing Address - Fax:
Practice Address - Street 1:1950 S SUNWEST LN STE 200
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3248
Practice Address - Country:US
Practice Address - Phone:909-252-4026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program