Healthcare Provider Details

I. General information

NPI: 1487584793
Provider Name (Legal Business Name): ALLEN GARCIA BORDMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4418 VINELAND AVE # 102
TOLUCA LAKE CA
91602-3457
US

IV. Provider business mailing address

4418 VINELAND AVE # 102
TOLUCA LAKE CA
91602-3457
US

V. Phone/Fax

Practice location:
  • Phone: 818-842-7145
  • Fax:
Mailing address:
  • Phone: 818-322-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95039289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: