Provider Demographics
NPI:1396162871
Name:GARCIA, BRIAN KEITH JR
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:KEITH
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5188 E. ASHLAN AVE.
Mailing Address - Street 2:#103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727
Mailing Address - Country:US
Mailing Address - Phone:559-241-9456
Mailing Address - Fax:
Practice Address - Street 1:5188 E ASHLAN AVE
Practice Address - Street 2:#103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-7367
Practice Address - Country:US
Practice Address - Phone:559-241-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker