Provider Demographics
NPI:1063597185
Name:GARCIA, SANDRA JAYNE (MC, LPC)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JAYNE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13856 N 56TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3012
Mailing Address - Country:US
Mailing Address - Phone:602-996-6975
Mailing Address - Fax:
Practice Address - Street 1:1232 E BROADWAY RD STE 120
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1510
Practice Address - Country:US
Practice Address - Phone:480-784-1514
Practice Address - Fax:480-736-4936
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10675101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor