Provider Demographics
NPI:1598378408
Name:GARCIA, AMELIA ANN (APCC)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:ANN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:ANN
Other - Last Name:VALOIS/GALLEGOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:421 E MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-0437
Mailing Address - Country:US
Mailing Address - Phone:209-525-5080
Mailing Address - Fax:
Practice Address - Street 1:421 E MORRIS AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0437
Practice Address - Country:US
Practice Address - Phone:209-525-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC6527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional