Healthcare Provider Details

I. General information

NPI: 1215862578
Provider Name (Legal Business Name): BRYANNA ITZEL GARCIA
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

1314 CORNET PL
SAN DIEGO CA
92154-3444
US

IV. Provider business mailing address

1314 CORNET PL
SAN DIEGO CA
92154-3444
US

V. Phone/Fax

Practice location:
  • Phone: 619-706-1777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: