Fabiana Garcia, RDH

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

124Q00000X Issued in OR

Practice address

18139 NE Couch St
Portland, OR 97230-7281

Phone

(503) 489-1760

NPI assigned

Jun 17, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Wallace Medical Concern

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1215390091
  NPD (past)
• The Wallace Medical Concern

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1841592110
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1215387402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18139 NE COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972307281",
            "telephone_number": "503-489-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18139 NE COUCH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972307281",
            "telephone_number": "503-489-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "FABIANA",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "OR",
            "license": "124Q00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel O Garcia, MSW
• David Dario Garcia
• Debra Olesen Garcia, MSW
• Denise Garcia
• Emily Garcia
• Flint Garcia
• Jennifer Garcia
• Jesus Garcia, CSFA
• Jesus Garcia
• Jillynn Garcia, LMFT

• Preferred Provider Organization in Portland, OR
• Providers in Portland, OR by specialty
• Preferred Provider Organization in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.