Provider Demographics
NPI:1124058540
Name:GARCIA, TERRY ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:ANN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:TERRY
Other - Middle Name:ANN
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12627 SANTA GERTRUDES AVE
Mailing Address - Street 2:STE B
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-2533
Mailing Address - Country:US
Mailing Address - Phone:562-947-8832
Mailing Address - Fax:562-947-8839
Practice Address - Street 1:12627 SANTA GERTRUDES AVE
Practice Address - Street 2:STE B
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2533
Practice Address - Country:US
Practice Address - Phone:714-905-2669
Practice Address - Fax:562-947-8839
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALSC227501041C0700X
CALCS227501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWSW22750AMedicare PIN