Provider Demographics
NPI:1467648527
Name:GARCIA, ANDREA M (MFT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-3638
Mailing Address - Country:US
Mailing Address - Phone:626-859-6200
Mailing Address - Fax:626-938-0397
Practice Address - Street 1:600 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-3638
Practice Address - Country:US
Practice Address - Phone:626-859-6200
Practice Address - Fax:626-938-0397
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF54507106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7544Medicaid