Provider Demographics
NPI:1851816821
Name:GARCIA, ANGELA ANTOINETTE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ANTOINETTE
Last Name: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 1:4548 LIMESTONE DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4436
Mailing Address - Country:US
Mailing Address - Phone:505-252-0533
Mailing Address - Fax:
Practice Address - Street 1:4548 LIMESTONE DR NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4436
Practice Address - Country:US
Practice Address - Phone:505-252-0533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-098891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical