Healthcare Provider Details

I. General information

NPI: 1508431172
Provider Name (Legal Business Name): YESENIA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5967 W 3RD ST STE 200
LOS ANGELES CA
90036-2835
US

IV. Provider business mailing address

6442 PLATT AVE # 138
WEST HILLS CA
91307-3216
US

V. Phone/Fax

Practice location:
  • Phone: 323-745-5800
  • Fax:
Mailing address:
  • Phone: 323-745-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89588
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: