Enedelia N/a Garcia

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

MPSS-BAMIJO Issued in CA

Practice address

800 Scenic Dr BLDG a
Modesto, CA 95350-6131

Phone

(209) 525-4982

NPI assigned

Apr 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Enedelia Aguallo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1609439108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR BLDG A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-4982",
            "fax_number": "209-558-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR BLDG A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-4982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "ENEDELIA",
        "middle_name": "N/A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "MPSS-BAMIJO",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ENEDELIA",
            "last_name": "AGUALLO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn Marie Garcia, CAARR GRADUATE
• Dolores V Garcia, AOD COUNSELOR
• Eduardo Garcia II, MSW
• Elizabeth Garcia
• Emily Garcia
• Ernestina Joseline Garcia
• Esperanza Garcia
• Felipe Garcia
• Gabriela Garcia
• Gavriela Garcia

• Peer Specialist in Modesto, CA
• Providers in Modesto, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.