Individual
SELENA ALICIA GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DTR
Contact information
Practice address
1287 FULTON RD, SANTA ROSA, CA 95401-4923
(877) 717-0085
Mailing address
2066 MENDOCINO AVE APT 59, SANTA ROSA, CA 95401-3653
(707) 934-7482
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
86291702
CA
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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