1790811354 NPI number — MS. TERRI L GARCIA CADC II-CA, CSC

Table of content: MS. TERRI L GARCIA CADC II-CA, CSC (NPI 1790811354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790811354 NPI number — MS. TERRI L GARCIA CADC II-CA, CSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
TERRI
Provider Middle Name:
L
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CADC II-CA, CSC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAGMANN
Provider Other First Name:
TERRI
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CADC II - CA, CSC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1790811354
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1620 ALPINE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALPINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91901-1102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-213-0778
Provider Business Mailing Address Fax Number:
619-213-0778

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1620 ALPINE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALPINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91901-1102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-213-0778
Provider Business Practice Location Address Fax Number:
619-213-0778
Provider Enumeration Date:
02/26/2007

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: 101YP2500X , with the licence number:  CSC - B1303111533 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: BII00460221 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X , with the licence number: AII054500418 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com