Provider Demographics
NPI:1720565211
Name:CINE GARCIA, BLANCA LETICIA
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:LETICIA
Last Name:CINE 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 1:1850 SAN BENITO ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4899
Mailing Address - Country:US
Mailing Address - Phone:831-801-2802
Mailing Address - Fax:
Practice Address - Street 1:1850 SAN BENITO ST
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-4899
Practice Address - Country:US
Practice Address - Phone:831-801-2802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator