Provider Demographics
NPI:1720787864
Name:GAIL GARCIA LICENSED CLINICAL SOCIAL WORKER INC
Entity Type:Organization
Organization Name:GAIL GARCIA LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-588-5817
Mailing Address - Street 1:236 W EAST AVE # A153
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7235
Mailing Address - Country:US
Mailing Address - Phone:530-624-2607
Mailing Address - Fax:
Practice Address - Street 1:1294 E 1ST AVE # 120
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1543
Practice Address - Country:US
Practice Address - Phone:530-588-5817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-27
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health