Provider Demographics
NPI:1124236955
Name:GARCIA, HEATHER
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26921 CROWN VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6501
Mailing Address - Country:US
Mailing Address - Phone:493-348-2889
Mailing Address - Fax:949-334-8294
Practice Address - Street 1:26921 CROWN VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6501
Practice Address - Country:US
Practice Address - Phone:493-348-2889
Practice Address - Fax:949-334-8294
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC052790518101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)