Provider Demographics
NPI:1528394640
Name:GARCIA, VINCENT EDUARDO
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:EDUARDO
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4873 E BUTLER AVE # 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-5063
Mailing Address - Country:US
Mailing Address - Phone:559-681-2310
Mailing Address - Fax:
Practice Address - Street 1:4928 E CLINTON WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1526
Practice Address - Country:US
Practice Address - Phone:559-255-8838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)