Provider Demographics
NPI:1467677104
Name:GARCIA, KRISTINE L (LM)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:L
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3234 MARYSVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-1411
Mailing Address - Country:US
Mailing Address - Phone:916-706-7480
Mailing Address - Fax:
Practice Address - Street 1:3234 MARYSVILLE BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-1411
Practice Address - Country:US
Practice Address - Phone:916-706-7480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM0130176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife