Provider Demographics
NPI:1215737259
Name:GARCIA, VANESSA
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-1921
Mailing Address - Country:US
Mailing Address - Phone:559-514-0878
Mailing Address - Fax:
Practice Address - Street 1:90 W ASHLAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-5627
Practice Address - Country:US
Practice Address - Phone:559-514-0878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator