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NPI Code Detail

MEDICARE: DIANNE GARCIA JR.

MEDICARE: DIANNE GARCIA JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1376327700
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANNE GARCIA JR.
Provider Business Mailing Address
First Line : 6246 KNOX AVE
Second Line :
City : FONTANA
State : CA
Zip : 92336-4517
Country : US
Telephone Number : 951-201-8455
Fax Number :
Provider Business Practice Location Address
First Line : 77711 FLORA RD STE 327
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-4103
Country : US
Telephone Number : 909-726-4030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2023
Last Update Date : 01/03/2026

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