Provider Demographics
NPI:1295914521
Name:GARCIA, ERIC (MSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1797 SAN JOSE AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-3078
Mailing Address - Country:US
Mailing Address - Phone:209-261-2930
Mailing Address - Fax:
Practice Address - Street 1:2645 E PLYMOUTH WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-5460
Practice Address - Country:US
Practice Address - Phone:209-261-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA851921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101076OtherMEDI-CAL