Provider Demographics
NPI:1982131199
Name:GARCIA, AARON (MS, ATC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15033 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94579-1713
Mailing Address - Country:US
Mailing Address - Phone:510-786-8364
Mailing Address - Fax:
Practice Address - Street 1:6121 HOLLIS ST STE 2
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2078
Practice Address - Country:US
Practice Address - Phone:925-701-1181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000273492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer