Provider Demographics
NPI:1023814290
Name:GARCIA PRADO, ESTEPHANIE
Entity type:Individual
Prefix:
First Name:ESTEPHANIE
Middle Name:
Last Name:GARCIA PRADO
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 1:1900 ASHBY RD SPC 2
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-4006
Mailing Address - Country:US
Mailing Address - Phone:209-285-9937
Mailing Address - Fax:
Practice Address - Street 1:1900 ASHBY RD SPC 2
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-4006
Practice Address - Country:US
Practice Address - Phone:209-285-9937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician