Healthcare Provider Details

I. General information

NPI: 1528514007
Provider Name (Legal Business Name): DEYSI RETANA-GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 CACERAS CIR
SALINAS CA
93906-2337
US

IV. Provider business mailing address

1441 CONSTITUTION BLVD BLDG 400 SUITE 202
SALINAS CA
93906-3100
US

V. Phone/Fax

Practice location:
  • Phone: 831-682-7649
  • Fax:
Mailing address:
  • Phone: 831-796-1705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: