1316460587 NPI number — ALMA NICOLE GARCIA DUARTE LMFT

Table of content: ALMA NICOLE GARCIA DUARTE LMFT (NPI 1316460587)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316460587 NPI number — ALMA NICOLE GARCIA DUARTE LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA DUARTE
Provider First Name:
ALMA
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316460587
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
78370 HIGHWAY 111 STE 245
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA QUINTA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92253-2622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-303-5173
Provider Business Mailing Address Fax Number:
760-303-5317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
72710 E LYNN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THOUSAND PALMS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92276-3312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-641-6235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2017

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: 106H00000X , with the licence number:  97017 , 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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