Provider Demographics
NPI:1285929240
Name:GARCIA, GINNA (MFT)
Entity type:Individual
Prefix:
First Name:GINNA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23133 HAWTHORNE BLVD.
Mailing Address - Street 2:SUITE 208
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2032
Mailing Address - Country:US
Mailing Address - Phone:310-849-2741
Mailing Address - Fax:
Practice Address - Street 1:11701 INGLEWOOD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2032
Practice Address - Country:US
Practice Address - Phone:310-849-2741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45556106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist