Healthcare Provider Details

I. General information

NPI: 1457058844
Provider Name (Legal Business Name): RUBI GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 S EASTERN AVE
COMMERCE CA
90040-4029
US

IV. Provider business mailing address

1508 E 110TH ST
LOS ANGELES CA
90059-1126
US

V. Phone/Fax

Practice location:
  • Phone: 323-725-4629
  • Fax:
Mailing address:
  • Phone: 323-697-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: