Provider Demographics
NPI:1295285823
Name:GARCIA, ERICA (DPT, PT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 MADERA RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3077
Mailing Address - Country:US
Mailing Address - Phone:805-306-1622
Mailing Address - Fax:805-306-1611
Practice Address - Street 1:1464 MADERA RD
Practice Address - Street 2:SUITE G
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3077
Practice Address - Country:US
Practice Address - Phone:805-306-1622
Practice Address - Fax:805-306-1611
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2920802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic