Provider Demographics
NPI:1760006688
Name:GARCIA, VALAREE ANN (BS COTA/L)
Entity Type:Individual
Prefix:
First Name:VALAREE
Middle Name:ANN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:BS COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 POPPY WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-1327
Mailing Address - Country:US
Mailing Address - Phone:818-427-7652
Mailing Address - Fax:
Practice Address - Street 1:1609 POPPY WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1327
Practice Address - Country:US
Practice Address - Phone:818-427-7652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5240224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant