Healthcare Provider Details

I. General information

NPI: 1114162773
Provider Name (Legal Business Name): MARIELLA GALARCEP R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W 1ST ST RM. 630
LOS ANGELES CA
90012-4112
US

IV. Provider business mailing address

100 W 1ST ST RM. 630
LOS ANGELES CA
90012-4112
US

V. Phone/Fax

Practice location:
  • Phone: 213-996-1300
  • Fax:
Mailing address:
  • Phone: 213-996-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number600270
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: