Healthcare Provider Details

I. General information

NPI: 1306328026
Provider Name (Legal Business Name): CHRISTOPHER DAVID GARZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 34TH ST
BAKERSFIELD CA
93301-2283
US

IV. Provider business mailing address

820 34TH ST
BAKERSFIELD CA
93301-2283
US

V. Phone/Fax

Practice location:
  • Phone: 661-205-3798
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95020005
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number751195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: