Provider Demographics
NPI:1154558922
Name:GARCIA, NICANOR STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:NICANOR
Middle Name:STEVEN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 MOHAWK ST STE 120
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1500
Mailing Address - Country:US
Mailing Address - Phone:661-634-0789
Mailing Address - Fax:888-887-4071
Practice Address - Street 1:841 MOHAWK ST STE 120
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1500
Practice Address - Country:US
Practice Address - Phone:661-634-0789
Practice Address - Fax:888-887-4071
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-18-32859103K00000X
CAPSY 22047103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst