Provider Demographics
NPI:1578876421
Name:GARCIA, JOANNA MARIE (RD)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MARIE
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 1:27136 EL MORO
Mailing Address - Street 2:UNIT 292
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-1006
Mailing Address - Country:US
Mailing Address - Phone:949-273-9555
Mailing Address - Fax:
Practice Address - Street 1:4540 CAMPUS DR
Practice Address - Street 2:SUITE 115
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1815
Practice Address - Country:US
Practice Address - Phone:949-874-3438
Practice Address - Fax:866-372-1190
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA919738133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered