Provider Demographics
NPI:1922441112
Name:GARCIA, ISMAEL
Entity Type:Individual
Prefix:MR
First Name:ISMAEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93927-5676
Mailing Address - Country:US
Mailing Address - Phone:831-674-2180
Mailing Address - Fax:
Practice Address - Street 1:14 PARK AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:CA
Practice Address - Zip Code:93927-5676
Practice Address - Country:US
Practice Address - Phone:831-674-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health