Healthcare Provider Details

I. General information

NPI: 1831065465
Provider Name (Legal Business Name): EVANINA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11509 OBERT AVE APT 9
WHITTIER CA
90604-2810
US

IV. Provider business mailing address

11509 OBERT AVE APT 9
WHITTIER CA
90604-2810
US

V. Phone/Fax

Practice location:
  • Phone: 562-547-1627
  • Fax:
Mailing address:
  • Phone: 562-547-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: