Provider Demographics
NPI:1255888202
Name:GARCIA, EDNA MELINA
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:MELINA
Last Name:GARCIA
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 1:3180 NEWBERRY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-1564
Mailing Address - Country:US
Mailing Address - Phone:408-793-0550
Mailing Address - Fax:408-266-0124
Practice Address - Street 1:3180 NEWBERRY DR
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-1564
Practice Address - Country:US
Practice Address - Phone:408-793-0550
Practice Address - Fax:408-266-0124
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator