Healthcare Provider Details

I. General information

NPI: 1720712599
Provider Name (Legal Business Name): LESLEY DIANA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 BEACH BLVD STE 205
BUENA PARK CA
90621-4030
US

IV. Provider business mailing address

9300 IMPERIAL HWY
DOWNEY CA
90242-2813
US

V. Phone/Fax

Practice location:
  • Phone: 714-736-0231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number538FC26A7C
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: