Provider Demographics
NPI:1265253785
Name:GARCIA, ELIRA GJATA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELIRA
Middle Name:GJATA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 PICKWICK DR # 805
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-9998
Mailing Address - Country:US
Mailing Address - Phone:805-722-9487
Mailing Address - Fax:
Practice Address - Street 1:1658 DEWAYNE AVE
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3815
Practice Address - Country:US
Practice Address - Phone:805-722-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1251021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical