Provider Demographics
NPI:1295920429
Name:GARCIA, ALISSA RACHEL (MFTI)
Entity type:Individual
Prefix:MISS
First Name:ALISSA
Middle Name:RACHEL
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:MISS
Other - First Name:ELISSA
Other - Middle Name:RACHEL
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:225 CABRILLO HWY S
Mailing Address - Street 2:#200A
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-8200
Mailing Address - Country:US
Mailing Address - Phone:650-573-2162
Mailing Address - Fax:
Practice Address - Street 1:225 CABRILLO HWY S
Practice Address - Street 2:#200A
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-8200
Practice Address - Country:US
Practice Address - Phone:650-573-2162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA107366150Medicare UPIN