Provider Demographics
NPI:1053550541
Name:GARCIA, HUMBERTO JR (PSC)
Entity type:Individual
Prefix:MR
First Name:HUMBERTO
Middle Name:
Last Name:GARCIA
Suffix:JR
Gender:M
Credentials:PSC
Other - Prefix:
Other - First Name:BERT
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSC
Mailing Address - Street 1:7743 BAIRNSDALE ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-2616
Mailing Address - Country:US
Mailing Address - Phone:562-505-5225
Mailing Address - Fax:
Practice Address - Street 1:12800 GARDEN GROVE BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2008
Practice Address - Country:US
Practice Address - Phone:714-620-8131
Practice Address - Fax:714-620-8132
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health