ME

Maria Elena Garcia

Active

Goes by “Mari”

Main OfficeLos Angeles, CAAge 41UCI: UCI-001

Profile

Identity

First Name
Maria
Middle Name
Elena
Last Name
Garcia
Preferred Name
Mari
Date of Birth
1985-03-15
Start Date
2020-01-10
Social Security #
***-**-1234
UCI #
UCI-001

Address

Address 1
123 Main St
Address 2
Apt 4B
City
Los Angeles
State
CA
Zip
90001
County
Los Angeles
Branch Office
Main Office

Contact

Home Phone
5551234567
Cell Phone
5551234568
Other Phone
—
Fax Number
—
Email
maria.garcia@email.com

Physical Description

Gender
Female
Height
5'4"
Weight
130
Eyes
Brown
Hair
Black
Ethnicity
Hispanic
Language
Spanish
Identifying
—

Notes

Communication Information
Prefers Spanish for medical discussions
Driving Directions
—

Additional Information

State Id #
—
SSI #
—
SSA #
—
Medicaid #
MC-12345
Medicare #
—
Jurisdictional Entity
RCOC
Comments
—
Shirt Size
M

Linked Clients

No linked clients

Status

ActiveCurrent status: Active

Support History

No status history