Provider Demographics
NPI:1083597744
Name:GARCIA, ISIS
Entity type:Individual
Prefix:
First Name:ISIS
Middle Name:
Last Name:GARCIA
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25250 EVERETT DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2418
Mailing Address - Country:US
Mailing Address - Phone:661-210-9181
Mailing Address - Fax:
Practice Address - Street 1:4880 MARKET ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7783
Practice Address - Country:US
Practice Address - Phone:805-644-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician