Provider Demographics
NPI:1235622036
Name:GARCIA, ALICIA RENEE
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:RENEE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4452 E. CESAR CHAVEZ BLVD.
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-3605
Mailing Address - Country:US
Mailing Address - Phone:559-600-0714
Mailing Address - Fax:
Practice Address - Street 1:4452 E. CESAR CHAVEZ BLVD.
Practice Address - Street 2:BUILDING #01
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702
Practice Address - Country:US
Practice Address - Phone:559-600-0714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT153655106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist