Provider Demographics
NPI:1740092352
Name:GARCIA, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
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 1:118 W AVENIDA DE LOS LOBOS MARINOS
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4358
Mailing Address - Country:US
Mailing Address - Phone:949-295-3230
Mailing Address - Fax:
Practice Address - Street 1:118 W AVENIDA DE LOS LOBOS MARINOS
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4358
Practice Address - Country:US
Practice Address - Phone:949-295-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program