Healthcare Provider Details

I. General information

NPI: 1659091247
Provider Name (Legal Business Name): TERRALYNN MICHELLE GARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 02/15/2026
Certification Date: 02/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4508 N SIERRA WAY
SAN BERNARDINO CA
92407-3854
US

IV. Provider business mailing address

13273 SARATOGA PL
CHINO CA
91710-4675
US

V. Phone/Fax

Practice location:
  • Phone: 800-207-0272
  • Fax:
Mailing address:
  • Phone: 909-263-0493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: