Healthcare Provider Details

I. General information

NPI: 1003571944
Provider Name (Legal Business Name): ROMELIA JALEH BATANG GARCIA RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/05/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US

IV. Provider business mailing address

536 SPENCER ST
GLENDALE CA
91202-1514
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-5012
  • Fax:
Mailing address:
  • Phone: 818-913-6502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number678277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: