Provider Demographics
NPI:1538599519
Name:GARCIA, TRUDY (MSW)
Entity type:Individual
Prefix:MS
First Name:TRUDY
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 PERCY ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-1716
Mailing Address - Country:US
Mailing Address - Phone:323-268-2100
Mailing Address - Fax:
Practice Address - Street 1:3455 PERCY ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023
Practice Address - Country:US
Practice Address - Phone:323-268-2100
Practice Address - Fax:323-268-2460
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA780131041C0700X
225400000X
CAASW78013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner