Healthcare Provider Details

I. General information

NPI: 1750860698
Provider Name (Legal Business Name): BERENICE GARCIA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BERENICE PADILLA

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 INLAND EMPIRE BLVD STE 101
ONTARIO CA
91764-4802
US

IV. Provider business mailing address

1096 LITTLE LEAF ST
CALIMESA CA
92320-4927
US

V. Phone/Fax

Practice location:
  • Phone: 909-483-5000
  • Fax:
Mailing address:
  • Phone: 909-483-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: