Healthcare Provider Details

I. General information

NPI: 1174489553
Provider Name (Legal Business Name): TANIA GALVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 N CENTRAL AVE STE A
GLENDALE CA
91203-3526
US

IV. Provider business mailing address

1036 W 54TH ST
LOS ANGELES CA
90037-3522
US

V. Phone/Fax

Practice location:
  • Phone: 661-360-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: