MEDICARE: KARINA GARCIA

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1992417356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARINA GARCIA

Provider Business Mailing Address
First Line	:	836 E 3RD ST
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91766-2012
Country	:	US
Telephone Number	:	909-630-8221
Fax Number	:

Provider Business Practice Location Address
First Line	:	4141 S NOGALES ST
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3056
Country	:	US
Telephone Number	:	661-205-3823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2022
Last Update Date	:	12/16/2022

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