Healthcare Provider Details

I. General information

NPI: 1811549991
Provider Name (Legal Business Name): WENDY JACQUELINE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 WILSHIRE BLVD STE 530
LOS ANGELES CA
90017-5733
US

IV. Provider business mailing address

1245 WILSHIRE BLVD STE 530
LOS ANGELES CA
90017-5733
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-4156
  • Fax:
Mailing address:
  • Phone: 213-977-4156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95008551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: