Provider Demographics
NPI:1346860780
Name:GARCIA, ALLISON (RD)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1862 N DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2920
Mailing Address - Country:US
Mailing Address - Phone:951-743-3656
Mailing Address - Fax:
Practice Address - Street 1:1862 N DIAMOND ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-2920
Practice Address - Country:US
Practice Address - Phone:951-743-3656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86069171133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty