Provider Demographics
NPI:1609755867
Name:GARCIA, DESTINY VIVIANA
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:VIVIANA
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 1:16626 SAMGERRY DR
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-4255
Mailing Address - Country:US
Mailing Address - Phone:323-537-0808
Mailing Address - Fax:
Practice Address - Street 1:1142 W BUXTON ST
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92377-8833
Practice Address - Country:US
Practice Address - Phone:909-419-0967
Practice Address - Fax:909-419-0967
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician