Provider Demographics
NPI:1538932108
Name:GARCIA, ITZAYANA (APCC)
Entity type:Individual
Prefix:
First Name:ITZAYANA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 CALLE AMISTAD UNIT 17303
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6960
Mailing Address - Country:US
Mailing Address - Phone:949-370-2986
Mailing Address - Fax:
Practice Address - Street 1:27141 ALISO CREEK RD
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3357
Practice Address - Country:US
Practice Address - Phone:949-643-6901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14580101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor