Healthcare Provider Details

I. General information

NPI: 1316760689
Provider Name (Legal Business Name): MARGUERITE GARRISON WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGUERITE JOANNE GARRISON MARGUERITE J. KAUL

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 S MAIN ST STE 470
ORANGE CA
92868-3859
US

IV. Provider business mailing address

1318 MONTEREY RD
SOUTH PASADENA CA
91030-3229
US

V. Phone/Fax

Practice location:
  • Phone: 714-734-3113
  • Fax:
Mailing address:
  • Phone: 858-220-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95032268
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: