Provider Demographics
NPI:1346599677
Name:GARCIA, LUIS LEYVA (MFTT)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:LEYVA
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MFTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 WEST HAMMER LANE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209
Mailing Address - Country:US
Mailing Address - Phone:209-444-8910
Mailing Address - Fax:
Practice Address - Street 1:1755 WEST HAMMER LANE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209
Practice Address - Country:US
Practice Address - Phone:209-444-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist