Provider Demographics
NPI:1487187241
Name:GARCIA, MONICA TERESA (BA, RADT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:TERESA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:BA, RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 S STAGE COACH LN
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2437
Mailing Address - Country:US
Mailing Address - Phone:760-453-8974
Mailing Address - Fax:
Practice Address - Street 1:147 S STAGE COACH LN
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2437
Practice Address - Country:US
Practice Address - Phone:760-453-8974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-09
Last Update Date:2017-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)