Provider Demographics
NPI:1740598408
Name:GARCIA, TRACY DENISE (AMFT)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:DENISE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12926 MERRY MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8545
Mailing Address - Country:US
Mailing Address - Phone:562-706-4971
Mailing Address - Fax:714-953-9155
Practice Address - Street 1:801 W SAN BERNARDINO RD
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3621
Practice Address - Country:US
Practice Address - Phone:626-541-0120
Practice Address - Fax:951-608-2624
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF131504106H00000X
CAIMF 63018106H00000X
CAIMF91927106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist