Provider Demographics
NPI:1609613926
Name:GARCIA, ALEXIS FERNANDA
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:FERNANDA
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 1:1241 S 55TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-4958
Mailing Address - Country:US
Mailing Address - Phone:510-778-2388
Mailing Address - Fax:
Practice Address - Street 1:51 MARINA BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-2068
Practice Address - Country:US
Practice Address - Phone:925-597-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker