Provider Demographics
NPI:1184065328
Name:GARZA, AMBER LEE (LMFT # 97120)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LEE
Last Name:GARZA
Suffix:
Gender:F
Credentials:LMFT # 97120
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CA
Mailing Address - Zip Code:95693-0889
Mailing Address - Country:US
Mailing Address - Phone:916-662-4771
Mailing Address - Fax:
Practice Address - Street 1:11080 JEFF BRIAN LN STE A120
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CA
Practice Address - Zip Code:95693-9514
Practice Address - Country:US
Practice Address - Phone:916-662-4771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97120106H00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator