Provider Demographics
NPI:1659587236
Name:GARCIA, GUY MANUEL (MA-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:MANUEL
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MA-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3905
Mailing Address - Country:US
Mailing Address - Phone:520-237-0396
Mailing Address - Fax:
Practice Address - Street 1:4317 4TH AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3905
Practice Address - Country:US
Practice Address - Phone:323-328-8412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22316235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist