Provider Demographics
NPI:1700163383
Name:GARCIA, LUZ
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:
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 1:1200 N MAIN ST STE 630
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-3633
Mailing Address - Country:US
Mailing Address - Phone:714-490-7711
Mailing Address - Fax:
Practice Address - Street 1:1200 N MAIN ST STE 630
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-3633
Practice Address - Country:US
Practice Address - Phone:714-824-8150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator