Healthcare Provider Details

I. General information

NPI: 1952236317
Provider Name (Legal Business Name): ZURISADAI GARCIA-TREJO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13079 VAN NUYS BLVD
PACOIMA CA
91331-2575
US

IV. Provider business mailing address

6714 JACARANDA AVE
FONTANA CA
92336-1331
US

V. Phone/Fax

Practice location:
  • Phone: 818-206-3353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: