Provider Demographics
NPI:1245599570
Name:GARCIA, CARLA PATRICIA (LCSW, PPSC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:PATRICIA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-4326
Mailing Address - Country:US
Mailing Address - Phone:661-631-5895
Mailing Address - Fax:661-631-5898
Practice Address - Street 1:2951 CENTER ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-5303
Practice Address - Country:US
Practice Address - Phone:661-631-3206
Practice Address - Fax:661-321-0011
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1600756261041S0200X
CALCSW887131041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator