Provider Demographics
NPI:1619748381
Name:GARCIA, ABIGAIL T
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:T
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16380 ROSCOE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-1221
Mailing Address - Country:US
Mailing Address - Phone:833-277-3454
Mailing Address - Fax:
Practice Address - Street 1:5900 S EASTERN AVE STE 156
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-4023
Practice Address - Country:US
Practice Address - Phone:833-277-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst