Healthcare Provider Details

I. General information

NPI: 1104088459
Provider Name (Legal Business Name): BRIANNE NAVARRO GARCIA LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W 5TH ST
SANTA ANA CA
92701-4519
US

IV. Provider business mailing address

6540 SKYLINKS DR
RIVERSIDE CA
92509-5778
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-3092
  • Fax:
Mailing address:
  • Phone: 951-202-2559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN223725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: