Provider Demographics
NPI:1750081238
Name:CANDELARIO GARCIA, ORLANDO
Entity type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:
Last Name:CANDELARIO GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2447 PRESIDENTE ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-6748
Mailing Address - Country:US
Mailing Address - Phone:209-910-2808
Mailing Address - Fax:
Practice Address - Street 1:2447 PRESIDENTE ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-6748
Practice Address - Country:US
Practice Address - Phone:209-910-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-21-197288103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst