Provider Demographics
NPI:1144434663
Name:GARCIA, NANCY COLLEEN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:COLLEEN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 DE LONG AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3252
Mailing Address - Country:US
Mailing Address - Phone:415-892-8992
Mailing Address - Fax:415-892-8962
Practice Address - Street 1:800 DE LONG AVE STE 100
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3252
Practice Address - Country:US
Practice Address - Phone:415-892-8992
Practice Address - Fax:415-892-8962
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 115771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical