Provider Demographics
NPI:1285866004
Name:GARCIA, RUBY
Entity Type:Individual
Prefix:MISS
First Name:RUBY
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12024 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-4509
Mailing Address - Country:US
Mailing Address - Phone:323-728-0100
Mailing Address - Fax:323-728-9218
Practice Address - Street 1:5723 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-4222
Practice Address - Country:US
Practice Address - Phone:323-728-0100
Practice Address - Fax:323-728-9218
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)