Basic Information
| Provider Information | |||||||||
| NPI: | 1194157495 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | PRISCILLA | ||||||||
| MiddleName: | PITTMAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 730 MEDICAL CENTER CT | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919116618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582782847 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 B ST STE 1570 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921014560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196150439 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2013 | ||||||||
| LastUpdateDate: | 03/01/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0807X | 796313 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent | 163WP0809X | 796313 | CA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.