Healthcare Provider Details

I. General information

NPI: 1205794567
Provider Name (Legal Business Name): TIFFANY ANN GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N 8TH ST FL 1
EL CENTRO CA
92243-2302
US

IV. Provider business mailing address

PO BOX 641
BRAWLEY CA
92227-0641
US

V. Phone/Fax

Practice location:
  • Phone: 442-265-1526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number748815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: