Provider Demographics
NPI:1114736097
Name:GARCIA, DENNIS JESUS II
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:JESUS
Last Name:GARCIA
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4010
Mailing Address - Country:US
Mailing Address - Phone:909-553-3443
Mailing Address - Fax:
Practice Address - Street 1:1301 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4010
Practice Address - Country:US
Practice Address - Phone:909-553-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician