Healthcare Provider Details

I. General information

NPI: 1326545146
Provider Name (Legal Business Name): STELLA GALARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 E ARROW HWY
POMONA CA
91767-2535
US

IV. Provider business mailing address

250 N COLLEGE PARK DR APT D22
UPLAND CA
91786-9459
US

V. Phone/Fax

Practice location:
  • Phone: 909-398-4383
  • Fax:
Mailing address:
  • Phone: 626-437-1459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4690
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: