Healthcare Provider Details

I. General information

NPI: 1205774106
Provider Name (Legal Business Name): MELODY LIZETTE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CORPORATE CENTER DR STE 120
MONTEREY PARK CA
91754-7610
US

IV. Provider business mailing address

921 N HICKS AVE
LOS ANGELES CA
90063-2703
US

V. Phone/Fax

Practice location:
  • Phone: 626-495-9420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: