Provider Demographics
NPI:1063873594
Name:GARCIA, ANITA LEE (MS)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:LEE
Last Name:GARCIA
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:LEE
Other - Last Name:ISRAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:5762 LINCOLN AVE # 268
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-9998
Mailing Address - Country:US
Mailing Address - Phone:714-823-7359
Mailing Address - Fax:
Practice Address - Street 1:2621 GREEN RIVER RD STE 105 #2100
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-7454
Practice Address - Country:US
Practice Address - Phone:714-823-7359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-11
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109331106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist