Provider Demographics
NPI:1326709981
Name:GARCIA, VANESSA (LPCC)
Entity type:Individual
Prefix:MISS
First Name:VANESSA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1444
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92609-1444
Mailing Address - Country:US
Mailing Address - Phone:909-333-6335
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1444
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92609-1444
Practice Address - Country:US
Practice Address - Phone:909-333-6335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA210256979101YS0200X
CA18266101YP2500X
CAAPCC10736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool