Healthcare Provider Details

I. General information

NPI: 1851758981
Provider Name (Legal Business Name): STEPHANIE GARCIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE GARCIA BUENAVENTURA

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR SOUTH
ORANGE CA
92868-3201
US

IV. Provider business mailing address

101 THE CITY DR SOUTH
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-7890
  • Fax:
Mailing address:
  • Phone: 714-456-7890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95024683
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number4262
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number95024683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: