Basic Information
| Provider Information | |||||||||
| NPI: | 1831481670 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | LINDA | ||||||||
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| Credential: | RRW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 406 SUNRISE AVE | ||||||||
| Address2: | SUITE 310A | ||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956614106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167978989 | ||||||||
| FaxNumber: | 9167978979 | ||||||||
| Practice Location | |||||||||
| Address1: | 1530 3RD ST | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | LINCOLN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956481562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164348927 | ||||||||
| FaxNumber: | 9164340678 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2011 | ||||||||
| LastUpdateDate: | 05/12/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.