Provider Demographics
NPI:1710008735
Name:GARCIA, JUAN LEYVA JR (MSW, ASW)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:LEYVA
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 N. SUTTER STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202
Mailing Address - Country:US
Mailing Address - Phone:209-933-1255
Mailing Address - Fax:209-444-8920
Practice Address - Street 1:42 N. SUTTER STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202
Practice Address - Country:US
Practice Address - Phone:209-933-1255
Practice Address - Fax:209-444-8920
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 155871041C0700X
CALCSW695001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical