Provider Demographics
NPI:1891329553
Name:GARCIA, CHRISTINA MARIE (HAD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 EUCALYPTUS ST STE B
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-4317
Mailing Address - Country:US
Mailing Address - Phone:209-823-2107
Mailing Address - Fax:209-823-0563
Practice Address - Street 1:1079 EUCALYPTUS ST STE B
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-4317
Practice Address - Country:US
Practice Address - Phone:209-823-2107
Practice Address - Fax:209-823-0563
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8594237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist