Provider Demographics
NPI:1508217357
Name:GARCIA, CRYSTAL C (LCSW)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:C
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 1:23811 WASHINGTON AVE # 261
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-2275
Mailing Address - Country:US
Mailing Address - Phone:805-816-0570
Mailing Address - Fax:
Practice Address - Street 1:23811 WASHINGTON AVE # 261
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-2275
Practice Address - Country:US
Practice Address - Phone:805-816-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1126461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA657905904OtherUNITEDHEALTHCARE