Provider Demographics
NPI:1821672023
Name:GARCIA, SARAH CORRINE (RADT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:CORRINE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:CORRINE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RADT
Mailing Address - Street 1:4363 TWEEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-6236
Mailing Address - Country:US
Mailing Address - Phone:323-378-2009
Mailing Address - Fax:
Practice Address - Street 1:4363 TWEEDY BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-6236
Practice Address - Country:US
Practice Address - Phone:323-378-2009
Practice Address - Fax:213-395-9592
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1415900121101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)