Healthcare Provider Details

I. General information

NPI: 1689239113
Provider Name (Legal Business Name): MONICA GARCIA RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY HEALTH SERVICES 2222 BANCROFT WAY MC4300
BERKELEY CA
94720-0001
US

IV. Provider business mailing address

1508 1ST AVE APT 4
OAKLAND CA
94606-1667
US

V. Phone/Fax

Practice location:
  • Phone: 510-643-5808
  • Fax:
Mailing address:
  • Phone: 510-289-6972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000788
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number780820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: