1124058540 NPI number — MRS. TERRY ANN GARCIA LCSW

Table of content: MRS. TERRY ANN GARCIA LCSW (NPI 1124058540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124058540 NPI number — MRS. TERRY ANN GARCIA LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
TERRY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MURPHY
Provider Other First Name:
TERRY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124058540
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12627 SANTA GERTRUDES AVE
Provider Second Line Business Mailing Address:
STE B
Provider Business Mailing Address City Name:
LA MIRADA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90638-2533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-947-8832
Provider Business Mailing Address Fax Number:
562-947-8839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12627 SANTA GERTRUDES AVE
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
LA MIRADA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90638-2533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-905-2669
Provider Business Practice Location Address Fax Number:
562-947-8839
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LSC22750 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: LCS22750 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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