Provider Demographics
NPI:1902192974
Name:GARCIA, MARIANA (CATC INTERN)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CATC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ALLERTON STREET
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062
Mailing Address - Country:US
Mailing Address - Phone:650-599-9955
Mailing Address - Fax:650-599-9273
Practice Address - Street 1:500 ALLERTON STREET
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062
Practice Address - Country:US
Practice Address - Phone:650-599-9955
Practice Address - Fax:650-599-9273
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)