Provider Demographics
NPI:1922484260
Name:GARCIA, JUAN (JOHN) DANIEL
Entity Type:Individual
Prefix:
First Name:JUAN (JOHN)
Middle Name:DANIEL
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 1:1420 WILLOW PASS RD # 200
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5823
Mailing Address - Country:US
Mailing Address - Phone:925-646-5480
Mailing Address - Fax:559-683-6499
Practice Address - Street 1:49774 ROAD 426 STE D
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-8691
Practice Address - Country:US
Practice Address - Phone:559-683-4809
Practice Address - Fax:559-683-6499
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health