Provider Demographics
NPI:1376016386
Name:GARCIA, LAURA BEATRIZ
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:BEATRIZ
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 1:74710 HIGHWAY 111 STE 102
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3820
Mailing Address - Country:US
Mailing Address - Phone:760-907-5247
Mailing Address - Fax:
Practice Address - Street 1:85184 CALLE ROSA
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-3400
Practice Address - Country:US
Practice Address - Phone:760-902-5247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst